piggyback lenses

[Renee101157]

I see in some of your answers that they now make implants in stronger powers.  I was born with a congenital
problem named nano?(small eyes).  I am now 54 years old and have cataracts.  After my measurements were
taken I was told that I need piggyback in both eyes.  I need a "50" and they do not make it.  I understand in other countries they custom make lenses, but is this dangerous.  I have worn contacts for year.  Rt eye+1550 and left +2100.  Piggyback seems to be my only option.  Any suggestions.  I would like to hear from someone who has had this done also.  Thanks for any advice.

[John C Hagan III, MD, FACS, FAAO]

Nanophthalmos is quite rare and surgery on same is even rarer. I would suggest Emory University Depart of Ophthalmology (where I trained) in Atlanta.

JCH MD

[Renee101157]

Can anyone tell me how to find a surgeon that has performed cataract surgery on a patient with nanopthalmus?

[John C Hagan III, MD, FACS, FAAO]

Your condition is likely nanophthalmos. Surgery is more complicated in that condition due to the small eye and narrow anterior segment. The eye may be more likely to bleed (choroidal effusion). The condition is relatively rare so be sure you have a gifted and skilled surgeon. And piggy back IOLs are likely your best choice.

JCH MD