Refractive Changes after Removal of Anterior IOLs in Temporary Piggyback IOL Implantation for Congenital Cataracts

PURPOSE: To assess the refractive change and prediction error after temporary intraocular lens (IOL) removal in temporary polypseudophakic eyes using IOL power calculation formulas and Gills' formula. METHODS: Four consecutive patients (7 eyes) who underwent temporary IOL explantation were enrolled. Postoperative refractions calculated using IOL power calculation formulas (SRK-II, SRK-T, Hoffer-Q, Holladay, and the modified Gills' formula for residual myopia and residual hyperopia) were compared to the manifest spherical equivalents checked at 1 month postoperatively. RESULTS: The mean ages of temporary piggyback IOL implantation and IOL removal were 6.71 ± 3.68 months (range, 3 to 12 months) and 51.14 ± 18.38 months (range, 29 to 74 months), respectively. The average refractive error was -13.11 ± 3.10 diopters (D) just before IOL removal, and improved to -1.99 ± 1.04 D after surgery. SRK-T showed the best prediction error of 1.17 ± 1.00 D. The modified Gills' formula for myopia yielded a relatively good result of 1.47 ± 1.27 D, with only the variable being axial length. CONCLUSIONS: Formulas to predict refractive change after temporary IOL removal in pediatric polypseudophakia were not as accurate as those used for single IOL implantation in adult eyes. Nonetheless, this study will be helpful in predicting postoperative refraction after temporary IOL removal.