Abstract

PURPOSE: To describe a novel technique for primary intracapsular polypseudophakia performed on a pediatric patient with unilateral posterior polar cataract in a nanophthalmic eye. METHODS: Phacoemulsification combined with primary posterior capsulotomy, anterior vitrectomy, and primary intracapsular polypseudophakia was performed to attain full refractive correction, resulting in a piggyback one-piece intraocular lens (IOL) in the capsular bag with posterior optic capture of an underlying three-piece IOL. RESULTS: There were no intraoperative or postoperative complications. By 2 months postoperatively, uncorrected distance visual acuity of 20/50 was achieved (secondary to amblyopia) with plano manifest refraction. CONCLUSIONS: This case demonstrates a useful technique in nanophthalmic or hypermetropic eyes for which alternative methods of correcting residual postoperative refractive error may be suboptimal. [ Journal of Refractive Surgery Case Reports . 2022;2(1):e14–e17.]

Highlights

  • There were no intraoperative or postoperative complications

  • The piggyback intraocular lens (IOL) is usually placed in the ciliary sulcus, but 10-year outcomes of patients who underwent implantation of polymethylmethacrylate (PMMA) IOLs within the capsular bag have reported long-term stability of intracapsular polypseudophakia.[1,2]

  • IOL exchange can be safe when performed in the early postoperative period, but explantation in the presence of capsular fibrotic adhesions can result in multiple complications, such as capsular rupture with vitreous loss.[3]

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Summary

METHODS

Phacoemulsification combined with primary posterior capsulotomy, anterior vitrectomy, and primary intracapsular polypseudophakia was performed to attain full refractive correction, resulting in a piggyback one-piece intraocular lens (IOL) in the capsular bag with posterior optic capture of an underlying three-piece IOL

CONCLUSIONS
RESULTS
DISCUSSION
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