Piggyback toric phakic implantable collamer lens: Management of pseudophakic ametropia and negative dysphotopsia.

As a result of the successful development of corneal refractive techniques over the past 3 decades, an increasing number of patients who have undergone refractive surgery are now seeking surgical solutions for dysfunctional or cataractous lenses, with high expectations for precise visual outcomes. Refractive calculation in these cases poses a challenge for the surgeon. One available option to address residual postoperative refractive errors after lensectomy is the implantation of a secondary implantable lens in a piggyback configuration. We present a unique case of implanting a collamer phakic implantable lens (ICL) in a piggyback fashion, addressing not only residual refractive error following cataract surgery but also severe negative dysphotopsia in a patient who had undergone LASIK 20 years earlier and already had a posterior capsulotomy.