Purpose: To compare central topography (CT) from IOLMaster 700 to predicate topographic maps (PT) from a Placido-dual-Scheimpflug tomographer in detection of irregularities that would influence the decision-making for implanting premium intraocular lenses (IOLs) (toric, multifocal, or extended depth-of-focus).Swetting: Cullen Eye Institute, Baylor College of Medicine, Houston, Texas.Design: Prospective comparative case series. Methods: Eyes with various corneal conditions were randomly selected: regular/irregular corneas, previous corneal refractive surgery, and keratoconus or pellucid marginal degeneration. Three observers compared the CT and PT maps and answered a questionnaire for each eye. The questionnaire focused on (1) overall shape similarity between CT and PT and ( 2) decision-making for premium IOL implantation based on CT and PT. Answers to the questionnaire and agreement in answers among observers were evaluated.Results: The study included 105 eyes. Comparing CT and PT, similar shape was observed in 68.6% to 89.5% of cases, and comparable map symmetries were reported in 60.0% to 83.8%; the same decision was made in 75.2% to 97.1% of cases for premium IOL implantation. There were significant inter-observer agreements among 3 observers for all questions, with Fleiss kappa values ranging from 0.141 to 0.450 (all P