CASE REPORT article
Front. Ophthalmol.
Sec. Lens and Cataract
Unique Case of Lens Replacement in High Hyperopia with Trifocal Lens and Piggyback Light Adjustable Lens Implantation
Provisionally accepted
- 1Texas Christian University Anne Burnett Marion School of Medicine, Fort Worth, United States
- 2Loyola University Chicago Department of Ophthalmology, Chicago, United States
- 3Parkhurst NuVision, San Antonio, United States
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Managing high hyperopia is notably challenging due to the unpredictability of refractive outcomes. Moreover, the technical difficulties of surgery in patients with smaller eyes, compounded by the limitations in available intraocular lens (IOL) powers in the United States, necessitate innovative approaches to achieve emmetropia. This case report discusses a novel approach using a light-adjustable lens (LAL) with a trifocal IOL to address these complexities and achieve spectacle independence. A 36-year-old male, who works as a military aircraft inspector, with high hyperopia and a history of left eye (OS) strabismic amblyopia, sought freedom from spectacles due to occupational demands. Pre-operative assessment showed severe uncorrected visual acuity and short axial lengths. Refractive lens exchange was performed bilaterally, utilizing a trifocal IOL combined with a light-adjustable lens OD and a high-powered monofocal lens OS. Postoperatively, significant improvement in visual acuity was observed, with heightened patient satisfaction. This case demonstrates the effectiveness of integrating a light-adjustable lens with a trifocal IOL to address high hyperopia in a less invasive manner and foster spectacle independence with patient satisfaction. Our approach offers promising implications for refractive surgery, highlighting the potential for tailored solutions in complex cases.
Keywords: case report, Light adjustable lens, Piggyback lens, High hyperopia, Refractive surgery
Received: 04 Jun 2025; Accepted: 24 Nov 2025.
Copyright: © 2025 Shafiee, Ali, Gadicherla and Nasser. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Anirudh Gadicherla
Taj Nasser
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