You may be surprised when I tell you that I continue to learn more and more from making surgical videos. Despite teaching cataract surgery for more than 20 years, there is still so much to learn. And one of my favorite ways of learning is from my colleagues. Shannon Wong MD is a cataract and refractive surgeon in Austin, Texas and he really brings an incredible level of expertise to his patients. When Shannon speaks, I listen and I have learned a tremendous amount from him over the past two decades. I learned from Dr Wong’s YouTube channel that he has enjoyed success with using an extended depth of focus IOL with some of his radial keratotomy (RK) patients.
In a previous video, I indicated that I would be hesitant to use an EDOF lens in an eye with corneal issues such as the irregularity caused by RK. After learning from Dr Wong and expanding my view, I decided to find an appropriate patient in which to implant the Alcon Vivity EDOF IOL. This patient had prior 8 cut RK with a large optical zone and a smooth and regular central cornea on topographic testing. The patient also had a strong desire for a wider range of vision without spectacles and also had very reasonable expectations. This was the perfect patient and I performed the cataract surgery with great success. The patient gained great visual acuity for both far and intermediate and only rarely wears reading glasses for closer viewing of small print. So, yes, there are patients with prior RK who can be good candidates for EDOF lens implants. Thank you Shannon for the many years of friendship and the important surgical pearls.
Click to learn from this video and to understand my thought process: