By Randy J. Epstein, MD
    Subspecialty Day 2011: Cornea
    Cataract/Anterior Segment, Cornea/External Disease, Refractive Mgmt/Intervention

    As cataract surgery becomes inseparable from refractive surgery, Dr. Randy Epstein advises surgeons to perform preoperative topography and tomography on every cataract patient, and especially those who receive premium IOLs. Topography helps quantify surface astigmatism, identify patients with corneal abnormalities that preclude the use of multifocal IOLs, and prepare for any postoperative surgical or spectacle correction. Dr. Epstein also recommends the use of the Pentacam for all cataract patients. Corneal tomography provides the surgeon with a measurement of true corneal power, which is essential for patients with previous laser refractive surgery but no preoperative data. The Pentacam can also be used to measure the density of the nucleus, providing objective grades for cataracts.