To present our experience with a pseudophakic piggyback intraocular lens (IOL) (Sulcoflex; Rayner Intraocular Lenses Ltd) in five eyes of four patients. One patient desired increased spectacle independence after bilateral LASIK and refractive lens exchange with an accommodating IOL. The remaining three patients with residual refractive error desired increased spectacle independence following cataract surgery with a monofocal IOL.