Refractive Secondary Lens Implant / Piggyback Lens

What is a Refractive Secondary Lens Implant?

Refractive Secondary Lens Implant, also known as piggyback intraocular lens implantation (IOL), is only suitable for people who have already had cataract surgery or lens replacement surgery with lens implant and are having to wear glasses or contact lenses for clear vision. 

The purpose of this surgery is to provide spectacle independence for most activities.

Reasons to have a refractive secondary lens implant

The surgery involves the insertion of a second lens implant in the eye that sits on top of the lens implanted after cataract or lens replacement surgery.

Secondary IOL options include:

  • Monofocal
  • Multifocal
  • Toric
  • Multifocal toric models

A secondary lens implant allows your ophthalmologist (eye specialist) to further correct refractive errors.

After cataract surgery, you may also experience a refractive error. We call this a refractive surprise.

The main symptom of a refractive error after cataract surgery is blurred vision at a distance where you were expecting to have quality vision. 

This is not common, but there are a number of reasons that you may experience a refractive surprise.

Reasons you might experience refractive error after cataract surgery include:

  • An error in estimating corneal power
  • Misplacement of a previous lens
  • Pre-existing astigmatism
  • Surgically-induced astigmatism
  • Extensive contact lens wear
  • Dry eye after surgery
  • Developing a corneal surface abnormality; for example, due to keratoconus

Speak to your ophthalmologist if you are concerned about the side effects of cataract or lens replacement surgery.

How long do refractive secondary lens implants last?

The secondary lenses are designed to last for a long time and have the potential to last the rest of your life. However, this is a reversible procedure.

Depending on your circumstances, we may need to discuss realistic expectations for this procedure. If you have a pre-existing condition that could affect your eye health, this could limit what we can offer. We may also need to recommend an alternative procedure, such as laser vision correction.

Speak with our ophthalmologists to discuss your suitability for a refractive secondary lens implant.

Benefits of refractive secondary lens implant

A key benefit of a refractive secondary lens implant is its reversibility. For instance, we may need to reverse the procedure if you damage the lens or if we need to alter your prescription.

Another benefit of a refractive secondary lens implant is that it avoids potential damage to the eye from removing your original lens. The original IOL may have strongly attached to the capsular bag (a thin membrane around the eye’s natural lens).

According to BioMed Central, this procedure is more accurate than an IOL exchange when treating residual refractive errors after cataract surgery.

Book an appointment

Pay attention to any ongoing symptoms you experience after cataract or lens replacement surgery. Book an appointment to discuss your side effects, how long they’ve lasted and how severe they are.

We’ll give you a thorough examination to ensure your eyes are recovering as they should be and recommend any necessary adjustments.

You can also contact Mr Tariq Ayoub for a second opinion if your cataract or lens replacement surgery was performed elsewhere.


    Anyone wearing spectacles or contact lens after cataract surgery or lens replacement surgery and would like to be spectacle or contact lens independent.

    The surgery is generally pain free as anaesthesia in the form of drops is used during the surgery to numb the eye.

    Yes you have the option of having both eyes done on the same day. Mr. Ayoub will discuss this option with you during the consultation

    The purpose of the surgery is to reduce the dependence on glasses/contact lens.

    • Severe infection or bleeding that can permanently affect your vision
    • Raised intraocular pressure
    • Retinal tear/detachment

    Generally most people are ready to return to work/general day-to-day activities 3 days after surgery. However, heavy lifting and strenuous activity should be avoided for 2 weeks after surgery.

    Mr. Ayoub will discuss your personal circumstances with you during your consultation.

    Driving can be resumed when the legal standard is met, typically one week after surgery. Mr. Ayoub will discuss your personal circumstances with you during your consultation.

    The alternative to secondary lens implant is Laser Vision Correction.

0330 128 1616

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