Clinical outcomes of the piggyback secondary implantation of a novel multifocal lens in the ciliary sulcus: A case series

Gerardo Valvecchia, Guadalupe Cervantes-Coste, Oscar Asis, Federico Pereyra, Manuel Garza-León, Gastón Gomez Caride, Leonardo Ferlini, Roberto Gonzalez-Salinas

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2 Citations (Scopus)


PURPOSE: Evaluate the clinical outcomes of the secondary piggyback add-on IOL implantation in the ciliary sulcus for pseudophakic patients previously implanted with a monofocal IOL, who pursue a spectacle-free option after IOL surgery.

METHODS: A prospective case series including seven pseudophakic patients who underwent an in-the-bag monofocal IOL implantation. All eyes underwent a piggyback IOL implantation of the new sulcus designed A4 AddOn IOL in the ciliary sulcus as a secondary procedure for pseudophakic patients pursuing a spectacle-free option for near and intermediate distance after IOL surgery.

RESULTS: Seven eyes from six patients were included in this study, from which 4 (71.43%) were female, with a mean age of 58.33 ± 3.5 years (range 54-63; 95% CI 54.66, 62.01). The postoperative spherical equivalent at the 3-month visit was -0.10 m ± 0.82. Also, the UDVA was 0.11 ± 0.08 logMAR, the UIVA 0.01 ± 0.03, and the UNVA 0.01 ± 0.03 3 months after their surgical procedure.

CONCLUSIONS: The A4 AddOn multifocal IOL's secondary piggyback implant is an efficient alternative for monofocal pseudophakic patients seeking presbyopia solutions. This sulcus-designed IOL provides an optimal visual outcome for near and distance vision.

Original languageEnglish
Pages (from-to)1367-1372
Number of pages6
JournalEuropean Journal of Ophthalmology
Issue number3
Early online date9 Jul 2021
Publication statusPublished - May 2023

Bibliographical note

Publisher Copyright:
© The Author(s) 2021.

All Science Journal Classification (ASJC) codes

  • Ophthalmology


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