title: Long-term results of clear lens extraction combined with piggyback intraocular lens implantation to correct high hyperopia.
abstract: OBJECTIVE
  To assess the refractive outcome of clear lensectomy combined with piggyback intraocular lens implantation in highly hyperopic patients.
  
  
  METHODS
  This case review included 19 eyes of 10 patients with high hyperopia and axial length less than 21mm. Intraocular lens power was calculated for emmetropia using the Holladay II formula in 17 eyes, and SRK/T formula in 2 eyes following clear lens extraction and piggyback intraocular lens implantation. Patients were examined periodically over 24 months for visual acuity and spherical equivalent (SE).
  
  
  RESULTS
  The mean postoperative SE at 24 months was 0.20±1.39D (range, -3.00 to 2.50D), better than preoperative 9.81±2.62D (range, +6.00 to +14.50D) (P<0.001). Five eyes had SE within ±0.5D of emmetropia and 11 eyes within ±1.00D at postoperative 24 months. The mean postoperative uncorrected visual acuity (UCVA) at 24 months was 0.60±0.36, significantly improved compared to preoperative 1.39±0.33 (P<0.001). The mean best-corrected visual acuity (BCVA) at 24 months was 0.49±0.35, not statistically different compared to preoperative 0.38±0.30 (P=0.34). Twelve eyes maintained and 1 gained 1 or more Snellen line of BCVA, 4 eyes lost 1 line, and 2 eyes lost 2 lines at 24 postoperative months. Twelve eyes best-corrected near visual acuity (BCNVA) achieved J1 at postoperative 24 months compared to preoperative 7 eyes and the other 7 eyes better than J3.
  
  
  CONCLUSIONS
  Clear lens extraction combined piggyback intraocular lens implantation appears to be an effective procedure to correct high hyperopia but mild overcorrection and intralenticular opacification may require secondary procedure.
authors.affiliation: Tianjin Medical University, No.22 Qixiangtai Rd, Tianjin 300070, China ; Tianjin Key Lab of Ophthalmology and Visual Science, Tianjin Eye Institute, Tianjin Eye Hospital, Clinical College of Ophthalmology, Tianjin Medical University, No.4 Gansu Rd, Tianjin 300020, China ; Clinic Barraquer of Ophthalmology, C/Laforja 88, Barcelona 08021, Spain.
authors.forename: Xia
authors.initials: X
authors.lastname: Hua
authors.forename: Xiao-Yong
authors.initials: XY
authors.lastname: Yuan
authors.forename: Hui
authors.initials: H
authors.lastname: Song
authors.forename: Xin
authors.initials: X
authors.lastname: Tang
keywords: high hyperopia; intraocular lens; piggyback