When combined with 1 drop of tropicamide 1% preoperatively, both formulations provided safe and effective intracameral dilation for cataract surgery; however, the epi-S solution was the more efficacious at each step of the procedure.

546 3. Orssengo GJ, Pye DC. Determination of the true intraocular pressure and modulus of elasticity of the human cornea in vivo. Bull Math Biol 1999; 61:551-557 4. Vito RP, Carnell PH. Finite element based mechanical models of the cornea for pressure and indenter loading. Refract Corneal Surg 1992; 8:146-151 5. Bryant MR, McDonnell PJ. Constitutive laws for biomechanical modeling of refractive surgery.

Although the exact composition of the material between the lenses could not be established, hypotheses were advanced to understand the pathological mechanism associated with this condition. This case is different from those in previous reports of opacification composed of cortex and cells between piggyback IOLs.

We present a case involving opacification of the apposing surfaces of 2 acrylic intraocular lenses (IOLs) that had been implanted in a piggyback fashion 16 months previously. Clinical observations derived from our experience with piggyback acrylic lens implantation are presented, along with a discussion of late complications of piggyback IOL implantation and recommendations.

We report 3 cases of bilateral piggyback lens implantation in which late hyperopic shift occurred associated with Elschnig pearl formation in the peripheral interface between the 2 lenses.