S02E04: Corneal Tomography - Presbyopia Correction at the Time of Cataract Surgery

This is the fourth episode of a 7-part series on presbyopia correction at the time of cataract surgery.  This podcast series forms part of a GENEYE digital course that has been developed by Dr Jacqueline Beltz for Advanced Ophthalmology Trainees in Victoria, Australia.  The full course is available at geneye.org.au under online training.  

So far, we’ve covered IOL options, patient selection and optimisation, and astigmatism correction and refractive targets.  There’s a lot to consider, especially when trifocal or EDOF IOLs that utilise diffractive technologies are planned.  

Corneal tomography has come up as an important topic in every episode so far.  One of the reasons why it’s important to know the status of the cornea is to consider the impact of higher order aberrations when combined with diffractive IOL technologies.  Patients with aberrated corneas can be highly symptomatic of positive dysphotopsias such as glare and haloes after trifocal IOLs, so it’s best to consider other options such as monofocal IOLs, small aperture IOLs or maybe even negative spherical aberration EDOFs in those cases.

Should we or should we not ALWAYS do tomography when we’re considering trifocal IOLs?  In this episode Dr Jacqueline Beltz is joined by Associate Professor Elaine Chong to answer this question and to discuss corneal tomography in this setting.  Elaine is a cataract, cornea and refractive surgeon in Melbourne.  She is director of ophthalmology at Royal Melbourne Hospital and also part of the Corneal Unit at The Eye and Ear Hospital.  Prior to these positions, Elaine underwent double subspecialty fellowship training - first in medical retina and later in cornea and refractive surgery.  It was at Singapore National Eye Centre that Elaine completed her corneal training.   

Please subscribe to this podcast and remember that the full digital course is available at geneye.org.au