Scheimpflug measurement of intraocular lens position after piggyback implantation of foldable intraocular lenses in eyes with high hyperopia
Accepted 11 August 2006.
Purpose
To investigate the position of 3-piece foldable intraocular lenses (IOLs) after piggyback implantation for high hyperopia.
Setting
University Eye Hospital, Johann Wolfgang Goethe University, Frankfurt am Main, Germany.
Methods
Eight eyes of 5 highly hyperopic patients had phacoemulsification and implantation of 2 foldable IOLs. In 3 eyes, both IOLs were implanted in the capsular bag. In 5 eyes, 1 IOL was placed in the capsular bag and the second IOL in the ciliary sulcus. Intraocular lens optic tilt and decentration, combined thickness of both IOLs, and anterior chamber depth (ACD) were measured postoperatively over a period of 18 months using Scheimpflug photography.
Results
All eyes with both IOLs in the capsular bag showed interpseudophakic opacification, with a mean increase in combined IOL thickness of 0.4 mm, a decrease in ACD of 0.3 mm, and a corresponding hyperopic shift of 4.00 diopters. Eyes in which the anterior IOL was placed in the ciliary sulcus showed no changes in refraction or combined IOL thickness. In these eyes, the anterior IOL had a higher mean decentration (0.49 mm ± 0.20 [SD] after 12 months) than the posterior IOL (0.21 ± 0.13 mm after 12 months).
Conclusions
Piggyback IOL implantation with placement of 2 foldable IOLs in the capsular bag can be followed by a hyperopic shift that may be caused in part by displacement of the IOLs. Placement of the anterior IOL in the ciliary sulcus can lead to higher decentration of this IOL.
From the Department of Ophthalmology (Baumeister, Kohnen), Johann Wolfgang Goethe University, Frankfurt am Main, Germany, and the College of Optometry (Baumeister), University of Houston, and the Cullen Eye Institute (Kohnen), Baylor College of Medicine, Houston, Texas, USA
Corresponding author: Thomas Kohnen, MD, Professor of Ophthalmology, Department of Ophthalmology, Johann Wolfgang Goethe-University, Theodor-Stern-Kai 7, 60590 Frankfurt am Main, Germany.
ABSTRACT