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Expert Interview Ocular Imaging
Recent Advances in Ocular Imaging
Techniques An Expert Interview with Parag A Majmudar
Chicago Cornea Consultants, Chicago, IL, US
Parag A Majmudar
Parag A Majmudar is a fellowship-trained corneal and refractive surgery specialist. After receiving his degree at the Medical College of
Pennsylvania in Philadelphia, where he was a member of the prestigious Alpha Omega Alpha Honor Society, Dr Majmudar completed his
ophthalmology residency at the University of Chicago, serving as Chief Resident in the Department of Ophthalmology. He followed his residency
with a subspecialty fellowship in cornea and external diseases and refractive surgery at Rush-Presbyterian St. Luke’s Medical Center in Chicago.
An active participant in clinical research activities, Dr Majmudar is a highly regarded lecturer and instructor on the subjects of corneal and
refractive surgery. Currently, he serves as an Associate Professor of Ophthalmology at Rush University in Chicago, as well as being the former
co-director of the Corneal Fellowship at Rush. Dr Majmudar is an active member of the American Society of Cataract and Refractive Surgery as
well as the American Academy of Ophthalmology, and he recently received the Academy’s Senior Achievement Award. He is an International
Council Representative from the US for the International Society of Refractive Surgery.
Keywords Ocular imaging, OCT, IOL
Disclosure: Parag A Majmudar has nothing to
disclose in relation to this article. No funding was
received in the publication of this article. This is an
expert interview and as such has not undergone
the journal’s standard peer review process.
Authorship: All named authors meet the International
Committee of Medical Journal Editors (ICMJE) criteria
for authorship of this manuscript, take responsibility
for the integrity of the work as a whole, and have
given final approval to the version to be published.
Open Access: This article is published under the
Creative Commons Attribution Noncommercial License,
which permits any noncommercial use, distribution,
adaptation, and reproduction provided the original
author(s) and source are given appropriate credit.
Received: September 1, 2017
Published Online: October 20, 2017
Citation: US Ophthalmic Review, 2017;10(2) 87–8
Corresponding Author: Parag A Majmudar,
1725 W Harrison St, Ste 928, Chicago, IL 60612, US.
I maging of the eye is an integral part of ophthalmic examination, and is essential for the
diagnosis, assessment of severity and progression, and evaluation of management of ocular
disease. Advances in imaging technology are progressing at a rapid pace. In an expert
interview Parag A Majmudar discussed a number of aspects of optical imaging including the role of
optical coherence tomography (OCT) in corneal and refractive surgery, optimal imaging of the
eye during toric intraocular lens (IOL) implantation, and the role of aberrometry during anterior
Q: What is the optimal procedure for pre- and intraoperative
imaging of the eye during toric IOL implantation?
Toric IOLs have perhaps enjoyed the greatest reproducible success of any premium lens type in
use over the past decade. However, their success depends greatly on accurate placement, and this
requires some effort on the part of the surgeon. Even simple measures, such as marking the limbus
pre-operatively with a marking pen, are generally sufficient in order to achieve consistently good
results. However, technology has definitely made an impact in this area. We are currently able to
image the cornea pre-operatively using advanced topography and biometry to take into consideration
the effect on posterior corneal astigmatism on our outcomes. We also have the ability to identify
landmarks on the ocular surface and in some cases project an image into the oculars of the operating
microscope in order to identify the correct axis of implantation.
Q: What is the role of aberrometry during anterior segment imaging?
Ray-tracing aberrometry plays a large role in our clinic in managing various aspects of refractive
surgery planning. We are able to identify the optimal procedure for patients—whether cornea-based
or lens-based, depending on the localization of the aberrations within the eye. In addition, aberrometry
is invaluable in troubleshooting complaints following refractive or cataract surgery especially with
multifocal IOLs. It is also an important patient education tool to help them understand the problems
of their visual system before surgery.
Q: How can the use of corneal imaging techniques improve
outcomes after refractive surgery?
The newest phase of refractive surgery worldwide, and more recently in the US, involves using
topography to plan and execute a refractive treatment that takes into consideration, not only the
lower order aberrations of sphere and cylinder, but also higher order corneal aberrations. Surgeons
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