In the latest installment of our 2025 Power List Perspectives series, the President of American European Congress of Ophthalmic Surgery (AECOS) and Rodgers Clark Endowed Chair in Ophthalmology, Kendall E. Donaldson, discusses presbyopia-correcting trends, and how she imagines future AI models might be employed pre-operatively for cataracts surgery.
What major trends in cataract and refractive surgery are catching your attention right now?
There are so many interesting trends in cataract and refractive surgery right now. I am very interested in making cataract surgery less “traumatic” to the patient, which includes advances toward improvements in fluidics and increasing efficiency to reduce the use of ultrasound during cataract surgery. I am also very interested in the trend toward bilateral same-day surgery and in-office cataract suites, which will certainly be the way we deliver care in the future.
I am carefully watching presbyopia correcting technology that will help us preserve quality of vision and reduce unwanted dysphotopsias, while increasing range of vision. In the meantime, while technology is improving, there are promising simulators that will help us better predict who will fall victim to unwanted side effects of diffractive technology. Currently, diffractive technology provides us [with] the greatest range of vision. However, while some patients are completely ecstatic with their outcome, a rare few will have incapacitating dysphotopsias. Better predictive models could help us advise our patients on lens choice prior to cataract surgery.
There are also several new accommodating lens technologies on the horizon that are very exciting, and I look forward to introducing them to my patients over the next decade.
In what ways do you think artificial intelligence and machine learning will impact cataract & refractive surgery?
I believe that artificial intelligence and machine learning is the future of cataract surgery, and ophthalmology, in general. We really have been using artificial intelligence (AI) for many years to allow us to interpret test results and compare to normative data bases. We also know that AI is better than human rating systems, with regard to evaluating several ophthalmic issues (grading conjunctival hyperemia, grading lens density, evaluating severity of AMD). I think that someday in the very near future, AI will analyze all of a patient’s pre-operative measurements for cataract surgery, and combine this data with the patient’s lifestyle, occupation, and interests, and will advise us which lens will be the best choice for the patient at the time of cataract surgery.
What advice would you give to your younger self?
I would advise my younger self to always keep an open mind and be open to new opportunities, even if they are not aligned with my original planned path. We meet so many people and are exposed to new technologies and opportunities every day. You never know when one of these opportunities will lead you down a new – and potentially better – path. So, every interaction should be treated like a potential opportunity for future growth.
