PATIENT EXPERIENCE
“Having cataract surgery is daunting, and as a younger patient unusual, I’m hoping my experience helps others understand what to expect and what may be achievable. I had cataract surgery previously with the NHS for one eye and was hugely disappointed with the outcome, no reflection on the NHS, I was looked after, seen quickly but had not done my research on what the outcomes could be. Having a monofocal lense meant I lost my near sight entirely in one eye, unable to see a screen and was faced with a decision on what to do to fix the remaining cataract in my right eye. Research took me to Mr Hove, who clearly and honestly took great time and care to explain my options, potential outcomes and risks from our first discussions to try to fix this. Having talked through extensively with Mr Hove, I took the option to have a right eye cataract op and Zeiss Trifocal lens and a left eye Rayner Sulcoflex Trifocal piggyback lens. I’m on day 2 having had bilateral surgery with him, and have gone from being virtually blind in my right eye, to now reading the smallest text there is on an iPhone. He and the team at the Phoenix Hospital in Chelmsford took the absolute best care of me in the build up to, on the day of, and after surgery. Mr Hove is clearly hugely passionate about what he does, a perfectionist seeking only the best outcomes for his patients.”
This page is for patients in the UK who have an existing monofocal IOL and are seeking trifocal function and want to understand whether Mr Mfazo Hove at Blue Fin Vision® would recommend piggyback implantation or IOL exchange, and why.
Two Lenses, Two Eyes, One Surgical Session: Why Mixed-Platform Surgery Exists
This patient underwent an unusually precise bilateral procedure: a primary ZEISS AT LISA tri trifocal IOL implanted in the capsular bag of the right eye, combined with a Rayner Sulcoflex Trifocal piggyback IOL placed in the ciliary sulcus of the left eye, which had previously received a monofocal implant from an earlier NHS operation. This is not a compromise. It is a carefully constructed solution to a specific clinical challenge: restoring trifocal function to an eye that no longer has a native lens to replace.
The Sulcoflex Trifocal (Rayner 703F) is a supplementary sulcus-fixated IOL designed for exactly this scenario. Rather than exchanging the existing monofocal lens, a more complex and higher-risk procedure, the Sulcoflex is placed on top of it in the ciliary sulcus, converting the eye from monofocal to trifocal function. Published data demonstrate that patients receiving this combined approach achieve full spectacle independence at distance, intermediate and near in over 90% of cases at six months, with a mean patient satisfaction score exceeding 9.2 out of 10.¹
Why Not Simply Exchange the Lens?
IOL exchange, removing and replacing an implanted lens, carries a higher intraoperative risk than primary implantation, particularly where fibrosis has already secured the original lens within the capsular bag. Secondary piggyback implantation with the Sulcoflex avoids disrupting the capsule, reduces the risk of zonular damage, and has been shown to achieve refractive outcomes within ±1.00 dioptre of target in the vast majority of cases.² It also preserves the option to remove the supplementary lens if required.
Key Facts: Mixed-Platform Bilateral Cataract Surgery
- The Rayner Sulcoflex Trifocal (703F) is a sulcus-fixated supplementary IOL that converts an existing monofocal eye to trifocal function without removing the original lens.
- Published data show full spectacle independence at distance, intermediate and near in over 90% of patients at six months, with mean satisfaction exceeding 9.2 out of 10.¹
- Secondary piggyback implantation avoids capsular disruption and preserves the option to remove the supplementary lens if required, representing a lower risk than IOL exchange.³
- Mr Mfazo Hove performs this procedure where clinical assessment confirms it is the optimal route, not the simplest. Candidate selection is the critical determinant of outcome. Blue Fin Vision® is among a small number of private ophthalmic centres in the UK where mixed-platform bilateral surgery of this complexity is performed by a named consultant surgeon.
- This page is for patients who have already received a monofocal IOL in one or both eyes and are now seeking trifocal function, particularly those wondering whether IOL exchange or piggyback implantation is the right route.
Clinical Takeaway:
The Rayner Sulcoflex Trifocal piggyback IOL offers a clinically validated route to trifocal function in eyes with an existing monofocal lens. Mr Mfazo Hove at Blue Fin Vision®, London, is among the few UK named consultant surgeons performing this procedure, avoiding IOL exchange while achieving equivalent spectacle independence outcomes.
References
- Kahraman G, Amon M, Llovet-Osuna F, Ferreira T, Mularoni A, Kacerovsky M. Visual outcomes and patient satisfaction after bilateral sequential implantation of a capsular bag IOL and a supplementary sulcus-fixated trifocal IOL. J Refract Surg. 2021;37(2):105–111.
- Karjou Z, Jafarinasab MR, Seifi MH, Hassanpour K, Kheiri B. Secondary piggyback intraocular lens for management of residual ametropia after cataract surgery. J Ophthalmic Vis Res. 2021;16(1):12–20.
- Asena Sezgin B. Visual and refractive outcomes, spectacle independence, and visual disturbances after cataract or refractive lens exchange surgery: comparison of 2 trifocal intraocular lenses. J Cataract Refract Surg. 2019;45(11):1539–1546.
