Piggyback IOL

[Mitsou]

I have a monofocal lense in my left eye (the result of a multi-focal lense having been explanted) and I have a cataract growing in the right eye.  My intention was to have another monofocal lense in the right eye, but my last visit to the Ophthalmologist left me puzzled and worried.  He is strongly suggesting a multi-focal implant in my right eye and then he would go back to my left eye and do a piggyback.  I have not seen anything on this site concerning this procedure and I got the impression that my Ophthalmologist has not done it yet, and therefore I would appreciate your opinion on the subject.  The problem is my fear of doing something that is still experimental and possibly paying with my eyesight.  I also would like to add that the vision in my left eye is poor as a result of the explanting.  If these were your eyes; would you consider it?

[James J Salz, M.D.]

I absolutely agree with JCH MD.  You need another opinion to  find out why you see poorly in the first eye before even considering surgery in the second eye.  I have perfromed many piggy back implants and although it is not "experimental" there are very few indications for doing this as we have a much wider range of implant powers than we had in the past.  If you had a poor result from a multifocal in the first eye, I question the wisdom of doing it in the second eye. Ask your general medical doctor to recommend someone in your area who is noted for perfrorming cataract surgery.

[John C Hagan]

You should probably seek a second opinion from an ophthalmic surgeon (Eye MD- Ophthalmologist) that does a great deal of cataract implant surgery.

If you mean that your vision without glasses is not good after the implant exchange I would personally not generally advise one of my patients to have another exchange or a piggy-back implant put in. If you vision with glasses is not good after the first operation then I would also ask for the consultant/second opinion eye surgeon why the vision is "poor" as a lens exchange by itself (without complications) should not decrease the vision.

I have said before that if I personally were having cataract surgery I would choose glasses and a monofocal implant.

JCH MD Eye Physician & Surgeon