Primary piggyback implantation using the Tecnis ZM900 multifocal intraocular lens: case series

PURPOSE: To assess the postoperative outcomes of primary piggyback implantation using the Tecnis ZM900 multifocal intraocular lens (IOL) (Advanced Medical Optics). SETTING: Hospital Oftalmológico de Brasília, Brasília, Brazil. METHODS: Patients who had phacoemulsification with primary piggyback IOL implantation were analyzed prospectively. In all cases, a Tecnis ZM900 multifocal IOL was implanted in the capsular bag and a second silicone IOL was implanted in the ciliary sulcus. Information collected included near and distance uncorrected visual acuity (UCVA), best corrected visual acuity (BCVA), and the spherical equivalent (SE) before and after the surgery. RESULTS: Twenty eyes of 12 patients were included in the study. They were followed for 6 months. The mean preoperative distance UCVA was 20/400. At the last follow-up (6 months), the mean distance UCVA was 20/29, significantly better than before referral (P<.001). The mean preoperative SE was +6.35 diopters (D) +/- 2.25 (SD). Six months after surgery, the mean SE was -0.25 +/- 0.40 D (range -1.00 to +0.50 D), significantly better than before referral (P<.001). No patient lost lines of BCVA after surgery. At the last follow-up, 90% of the eyes achieved a near UCVA of J1 and 83.3% of patients were spectacle independent for near and distance vision. A second refractive procedure was performed in 2 eyes. CONCLUSIONS: Primary piggyback implantation using the Tecnis ZM900 multifocal IOL was a simple, safe, and accurate option for patients with high hyperopia who wanted to reduce their dependency on spectacles.