Duncker GIW, et al. - This study was undertaken to determine if residual refractive error after in-the-bag multifocal intraocular lens (mIOL) implantation may safely and efficaciously be corrected with a piggy-back low power Visian Toric Implantable Collamer Lens® (VTICL, STAAR Surgical) placed in the ciliary sulcus. The study sample consisted of 24 eyes of 23 patients (mean age was 57.5 years) with diminished uncorrected distance visual acuity (UDVA) of ≥ 2 lines due to residual refractive error after mIOL implantation. Data reported that mean UDVA (logMAR) increased from 0.26 preoperatively to −0.01 while mean corrected distance visual acuity remained unchanged at 6 months. From the preoperative target axis, mean VTICL misalignment was 5.3° and mean vault was 1385 μm. Two VTICL had to be exchanged due to oversizing in the initial phase of the study.After mIOL implantation, piggy-back low power VTICL can effectively correct the residual refractive error and increase UDVA significantly. VTICL availability in small diopter steps, no significant surgical-induced astigmatism, atraumatic and reversible procedure were the advantages of this novel surgical approach.