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Up Front | Jun 2007

5 Questions With Thomas Kohnen, MD

Professor Kohnen is focusing on clinical and experimental cataract and refractive treatments.

1. How did you become involved in ophthalmology?
My ophthalmic career began after I switched universities, almost halfway through medical school. I had just returned from studying with my brother (who is also an ophthalmologist) in South America, when I decided to transfer from the University of Aachen to the University of Bonn. It was here that I attended an ophthalmic course on the development of cataracts and pharmaceutical treatments. I found the experimental treatments fascinating, and I later approached the professor about writing my thesis with him.

When I first began practicing medicine at clinics, my colleagues spoke about how continuous advances in the field made coming to work everyday interesting.

I am now the Deputy Chairman and Professor of Ophthalmology at Johann Wolfgang Goethe-University, as well as a researcher, surgeon, consultant, and editor for several ophthalmic journals.

2. What is the focus of your current research?
My current research focuses on clinical and experimental cataract and refractive surgery treatments. For example, I have been working on clinical research for accommodating IOLs and other solutions for excimer laser surgery, as well as researching femtosecond laser surgery and phakic IOLs.

I am a part of a group of researchers in the United States performing experimental research with primates on new accommodative solutions. I also have another researcher working with my team on experimental optics.

In cataract surgery, I am looking at pharmacological treatments for posterior capsule opacification. My clinical research focuses on new toric and multifocal IOLs.

3. What do you feel will be the most promising advance for the future of refractive surgery?
There are several. I think, if we can achieve it, intrastromal ablation will be a real breakthrough. The ultimate goal is to have a laser treatment that does not require opening the cornea—where we would find a way to treat the patient without a LASIK flap.

I also think that developing a method to prevent corneal implant rejection in hyperopic patients would be a great advance for refractive surgery.

Lastly, everyone becomes presbyopic as they age. A breakthrough that addresses accommodation with this patient population would have the greatest potential impact on vision.

4. What do you think is the biggest challenge in refractive surgery?
I think ophthalmologists need to avoid merely practicing refractive surgery as a moneymaker. I have absolutely nothing against specialization, but I see too many people focusing solely on refractive surgery because of its high income potential and disregarding the rest of their training. We need to remain committed to helping the patient first and making sure that our priorities are in the correct order.

5. As an opinion leader, what advice would you give to future ophthalmologists?
Learn the basics of ophthalmology at good institutions so that you understand the field inside and out. Surgery is something you have to do by heart, but a strong educational foundation will aid you in this. If you do your job with passion and all of the knowledge you have gained, you will become a good ophthalmologist.

Bonus Question. Of all your areas of interest, which is your favorite and why?
I really like what I currently do, because it encompasses all parts of medicine. I can diagnose, and I can treat using pharmacological agents, but I can also perform surgery and practice patient care—it is internal medicine and surgery in one. I like investigating new ideas while working with younger residents and my esteemed colleagues. I also enjoy teaching and bringing new students into the field. It is the combination of these tasks that makes my job extremely interesting.