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Piggy back IOL for treatment of a refractive surprise after cataract surgery A patient was referred for treatment after routine cataract surgery. After the original surgery a post-op hypermetropic refractive surprise was noted Uncorrected visual acuity (UCVA) = 20/50 Best corrected visual acuity (BCVA) = 2020 with +2.00D Management of the postop refractive surprise involved implantation of a +3.50D 1stQ AddOn piggyback intraocular lens. Following implantation of the piggyback IOL, the UCVA improved to 20/20 Surgery performed in 2023 by Dr Simon Chen, Vision Eye Institute, Sydney, Australia. http://www.visioneyeinstitute.com.au/... Time stamps: 00:00 Case History 00:18 2 x 1mm side port incisions 00:30 Injection of intracameral lignocaine and phenylephrine. Viscoelastic injection 00:44 2.75mm corneal incision 00:54 Preparing 1stQ AddOn piggyback IOL for injection 01:19 Close up view of the 1stQ AddOn piggyback intraocular lens 01:30 Loading piggyback IOL into lens injector cartridge 02:06 Injecting the piggyback IOL through the 2.75mm corneal incision 02:37 Positioning the piggyback IOL into the ciliary sulcus 03:12 Removal of viscoelastic 03:41 Hydrating the corneal incisions 03:44 Intracameral injection of acetylcholine to constrict pupil and antibiotic to prevent infection