The piggyback method of implanting two intraocular lenses in one eye has been successfully expanded to address pseudophakic refractive error in normal eyes and eyes that have undergone postpenetrating keratoplasty. Piggyback implantation has been combined with the use of newly available minus-power lenses to provide appropriate power for a cataract patient with keratoconus, as well as to correct pseudophakic myopia. The phenomenon of increased depth of focus in piggybacks may be explained by a contact zone between the lenses. The late complication of interlenticular cellular growth with resultant hyperopic shift, opacification, and loss of vision has recently become a concern.
St. Luke's Cataract and Laser Institute, Tarpon Springs, Florida, USA
Correspondence to R.E. Fenzl, St. Luke's Cataract and Laser Institute, 43309 US Highway 19 N, Tarpon Springs, FL 34683, USA