This video shows an 8-month-old chosen to receive a pair of IOLs, one in the capsular bag and a second lens in the ciliary sulcus. Piggyback IOLs are used most often in unilateral applications when a contact lens will be poorly tolerated or managed by the patient's parents. In this case, Dr. M. Edward Wilson places a 1-piece acrylic IOL in the capsular bag and then removes all OVD from the bag. Viscoelastic is used to reinflate the sulcus and create space for a 3-piece acrylic lens, which is manually folded and inserted. Once the eye grows, this temporary lens can be removed easily without disturbing the capsule-fixated IOL. At the conclusion of the case, the corneal tunnel is sutured, and the posterior capsule is removed through a pars plana approach.