J Korean Ophthalmol Soc.  2010 Jul;51(7):1016-1022. 10.3341/jkos.2010.51.7.1016.

Cataract Surgery Using Piggyback Method in Patient With Nanophthalmos

• Lee JW
• Choi WS
• Park YJ
• Lee KW

• KMID: 2213794
• DOI: http://doi.org/10.3341/jkos.2010.51.7.1016

Abstract

PURPOSE
To report a case of cataract surgery using a piggyback method in a patient with pure nanophthalmos with an axial length under 16.00 mm in both eyes.
CASE SUMMARY
The authors performed cataract surgery using a piggyback method inserting two intraocular lenses (IOLs) in a 44-year-old male with nanophthalmos with axial lengths of OD 15.36 mm, and OS 15.59 mm. Primary implantation of two IOLs of +53.0D as calculated by the SRK/T and Holladay formula was performed in the right eye using a piggyback method. In the left eye, two IOLs of +60.0D calculated by the Hoffer Q formula were implanted. Postoperative hyperopic refractive errors occurred in both eyes. The differences between the preoperative target spherical equivalent (SE) and the postoperative one year four month SE were 9.68D in the right eye and 1.63D in the left eye.
CONCLUSIONS
Due to high diopter IOL requirements in nanophthalmic patients (less than 16.00 mm) during cataract surgery, the refractive errors were well corrected, without complications, by using a piggyback method. In the present case study, the Hoffer Q formula produced better results than did the SRK/T or Holladay formula in reducing the difference in preoperative and postoperative SEs, but more surgical cases and research are required to establish the most appropriate formula for cataract surgery in nanophthalmos.

Keyword

Nanophthalmos; Piggyback method

MeSH Terms

Adult
Cataract
Eye
Humans
Lenses, Intraocular
Male
Refractive Errors

Figure

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  Figure 1. A and B-scan (measured by US-3000® (NIDEK, Japan)) image showing the axial lengths of the nanophthalmos patient (A and B: OD, C and D: OS)

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  Figure 2. Slit lamp photography at post-op 1year 4months (A: Shows 2 well-placed IOLs in the capsular bag. B: Posterior capsular opacity or interlenticular opacity were not observed upon retroillumination.)

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