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Up Front | Jan 2008

5 questions with Simonetta Morselli, MD

Simonetta Morselli, MD, is the Director of Anterior Segment Surgery at the Hospital and University of Verona, Italy.

1. What is the greatest challenge that you have faced in your career?
I had some problems when I first entered the operating theatre about 10 years ago because I was not a man. It took several years before I was accepted as a surgeon by both the hospital staff and patients.

Additionally, when I first began performing surgery, the deep sclerectomy technique for the treatment of glaucoma gave me a lot of trouble. I had a hard time trusting that I could find the Schlemm's channel position, because its depth and distance from the limbus varies in each eye. I was extremely intimidated by the technique. It was actually Roberto Bellucci, MD, the chief here at the University of Verona, who helped me to learn the correct procedure and feel more comfortable performing it.

2. What is your proudest accomplishment?
I am very proud of what I did for the organization of the outpatient surgery service in my hospital. Approximately 9 years ago, the former chief of the department did not like the way that things were run. I convinced him to organize cataract surgery in a new way. I began working to organize surgery so that patients who received cataract surgery in the morning could go home after 2 or 3 hours. I also organized all of the details of the hospital including the nurses, scheduling, surgery, and location of the patient. The surgery plan that I developed is still in use today.

3. What is something that people would be surprised to learn about you?
People might not know that I am a good cook. I love to cook fish and good Italian food for my husband and friends several times a week. In fact, in 2005, I was featured on a national television channel called Gambero Rosso RAI SAT, cooking a personal recipe I invented consisting of soup, scallops, and Verona celery. A lot of Italian ophthalmologists have seen the show and have since asked to taste that soup! It makes me think that I should organize an ophthalmologist cooking congress.

From a professional standpoint, people are surprised by my work in personalizing spherical aberration in cataract surgery. I began this 2 years ago, after observing the poor results we had with standard and aspheric IOLs, especially in eyes that underwent previous refractive corneal surgery.

To get more accurate results in terms of optical quality—especially in corneas where the spherical aberration had changed because of refractive surgery—I realized that we needed a way of measuring the spherical aberration of only the cornea. I started measuring the aberration of the corneal surface with a Placido disc topographer.

With this new information, I was then able to choose the type of IOL that the patient would need after surgery to compensate for the corneal aberration and to improve the optical quality. For example, if the patient was originally myopic, I knew that refractive surgery would induce positive corneal spherical aberrations. During cataract surgery, the patient would need an IOL with negative spherical aberration to correct the positive corneal spherical aberration. If after refractive surgery the patient had neutral spherical aberration or other complex aberrations, I began using an IOL with neutral spherical aberration. If the patient had negative spherical aberration preoperatively, I would implant an IOL with positive spherical aberration. This has been a common practice of mine for the last 2 years.

4. What is your favorite aspect of your job?
I am extremely satisfied when my patients are satisfied. I love it when patients come back and thank me for giving them the ability to see. Whether it is granting them the ability to perform their job, see their children, or simply enjoy the scenery, I find great joy in giving them those opportunities.

5. What do you feel is the most promising future innovation in ophthalmology?
I feel like there are several promising technologies in the pipeline. The newest generation of IOLs provides a variety of choices that will allow cataract surgeons to customize the refractive and optical results according to patients' individual requirements and lifestyle. Additionally, corneal cross-linking, endothelial cell transplants, and femtosecond laser corneal surgery are exciting technologies. From a social point of view, the anti-VEGF therapies will bring light to patients with age-related macular degeneration.

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