Piggyback intraocular lens implant to correct severe refractive error after penetrating keratoplasty in pseudophakes

This letter describes two cases in which severe refractive error after penetrating keratoplasty (PK) in pseudophakes was corrected with piggyback intraocular lens (IOL) implantation. A 65-year-old woman had bilateral phacoemulsification and IOL implantation for cataract. After surgery, she developed right corneal decompensation. There was evidence of Fuch’s endothelial dystrophy in her fellow eye. This was managed with right PK. After the operation, acuity was 6/12 with correction −7.50/+1.00 × 140. This high myopia was then corrected with right spherical piggyback IOL implantation. Preoperative measurements included subjective refraction, back vertex distance, axial length, anterior chamber depth (IOL Master; Carl Zeiss Meditec, Welwyn Garden City, Hertfordshire, UK), white–white measurements, keratometric values and topography. These measurements were used …