Häberle H., Wirbelauer C., Pham D. T.

Augenabteilung Krankenhaus Neukölln - ein Haus der NET-GE Kliniken für Berlin GmbH, Rudower Str. 48, 12353 Berlin

Objective: After long standing pseudophakia or previous laser capsulotomy lens exchange for anisometropia or incorrect refraction is a difficult procedure. Piggybag lens implantation might be a less traumatic surgical alternative.
Methods: 6 patients had a secondary posterior chamber lens implant (PMMA) into the ciliary sulcus. Lens power was estimated by the preoperative refraction according to refractive vergence formula and was controlled intraoperatively by an automatic refractometer. Surgical access minimized preoperative astigmatism.
Results: All patients had disturbing anisometropia and underwent cataract surgery 1 to 13 years before. Once the piggybag lens implantation was combined with surgical aspiration of secondary cataract. One patient had because of recurrent PVR retinal detachment silicon oil refilling procedure and piggybag lens implantation. Preoperative spherical equivalent was -8.5 D and +1.5 D. Postoperative surgical equivalent was -0.25 D to -3.0 D. Mean absolute deviation of the intended refraction was 0.68 D. Mean follow up time 9 months. Elevated IOP or secondary cataract formation in the lens interface were not observed. Once pigment dispersion occured.
Conclusion: Secondary piggybag lens implantation into the ciliary sulcus on an existing posterior chamber lens is a safe and effective refractive surgical procedure for special cases with well predictable refraction.

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