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In this video, we share pearls for piggyback IOL Implantation. First reported by Johnny Gayton, M.D., in 1993, piggyback placement of an IOL can be a successful strategy for correcting residual refractive error. Placing an additional IOL (in a piggyback manner) in the eye is an effective way to correct a residual refractive error, particularly high degrees of refractive surprise. With the original IOL placed in the capsular bag, the piggyback IOL is traditionally placed in the ciliary sulcus to avoid interventricular opacity (ILO). These IOLs can be implanted during cataract surgery or clear lens extraction and IOL insertion (primary piggyback implantation) or as a secondary procedure following the initial IOL implantation (secondary piggyback implantation). Excellent details of IOL power calculation for piggyback are available on Dr. Warren Hill's website- http://www.doctor-hill.com/iol-main/p... IOL Power calculation for piggyback IOLs is based on residual refractive error and can achieve highly accurate outcomes. For minus (myopic) refractions, multiply the spherical equivalent by 1.2 to determine the piggyback IOL power. For plus (hyperopic) refractions, multiply the spherical equivalent by 1.5 to determine the piggyback IOL power. Complications, of the procedure, include interventricular opacification (ILO), pigment dispersion, iridocyclitis, glaucoma, and hyphema, which can be avoided with proper preoperative planning and IOL selection and IOL placement. About Dr. Suresh K Pandey- A medical graduate of Rani Durgawati University, Medical College, Jabalpur, M.P., India; Dr. Pandey completed his residency in Ophthalmology from the prestigious Postgraduate Institute of Medical Education and Research, Chandigarh, India. He worked at the University of Utah, USA & University of Sydney, Australia from1998 to 2006. Dr. Pandey returned to India in 2006 to establish SuVi Eye Institute and Research Center in Kota, Rajasthan, India (www.suvieye.com). Dr. Pandey has presented more than 150 scientific papers in various international ophthalmological meetings and authored more than 100 scientific papers/communications, 50 textbook chapters, and 10 ophthalmic textbooks. Dr. Pandey can be reached at Suvi Eye Institute and Research Center, C 13 Talwandi, Kota, Rajasthan, India; E-mail- [email protected], www.suvieye.com #DrSureshKPandeyKota #SuViEyeHospitalKota #SuViEyeHospitalLasikLaserCenterKota