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15:30
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潘志勤 Chih-Chin PanTaiwan
Moderator
眼科醫師在校園視力保健及公共衛生推廣中的角色摘要
眼科醫師在校園視力保健及公共衛生推廣中，扮演著遠超過「診療者」的多元且關鍵角色。他們是整個視力保健體系中的專家、倡議者、教育者與把關者。
眼科醫師在此領域中的多重角色：
一、 校園視力保健中的直接角色
在校園這個第一線場域，眼科醫師的角色從被動治療轉為主動出擊。
二、 公共衛生推廣中的核心角色
在更宏觀的公衛層面，眼科醫師是政策與民眾之間的橋樑，是推動全民視覺健康的引擎。
總結
眼科醫師在校園視力保健與公衛推廣中的角色，已從傳統的「醫療端」向前延伸至「預防端」和「政策端」。對於提升整體國民的視覺健康與生活品質，及一個國家的公共衛生和發展至關重要。
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Filomena RIBEIROPortugal
Speaker
Neuroadaptation in Premium IOL PatientsNeuroadaptation is a key determinant of visual success and satisfaction after implantation of premium intraocular lenses. This session will discuss how the brain adapts to new optical conditions created by simultaneous vision IOLs, integrating multiple focal points while minimising photic phenomena. Clinical data and patient-reported outcomes will illustrate the variability and time course of adaptation, highlighting the influence of IOL design and individual neural plasticity. Understanding and supporting neuroadaptation are essential to optimise outcomes and enhance patient experience with modern premium IOL technologies.ESCRS Multiformulas IOL Power Calculator AccuracyAccurate intraocular lens (IOL) power calculation remains a critical determinant of refractive outcomes following cataract surgery. The ESCRS IOL Calculator integrates modern formulas to improve prediction accuracy and support IOL selection across diverse biometric profiles. This lecture will review recent data assessing the performance of the ESCRS Calculator in comparison with individual formulas, focusing on its refractive predictability, consistency across axial lengths, and clinical usability.
Results from validation studies and real-world datasets will be presented, highlighting the calculator’s strengths and limitations, as well as its role in optimising outcomes in standard and challenging eyes. The session will also address practical considerations for integration into clinical workflow and the ongoing evolution of formula combinations as biometry and lens technology continue to advance.
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Prin RojanapongpunThailand
Speaker
Intraoperative Aberrometry: Benefits or Distractions?Intraoperative Aberrometry (IA) is a microscope-mounted aberrometer that uses a laser wavefront analyzer to provide an intraoperative refractometer with live measurement. IA utilizes real-time wavefront analysis to measure IOL power in the aphakic state (after I&A but before IOL implantation), guiding Toric IOL axis alignment, and confirming final refraction in the pseudophakic stage (after IOL implantation). IA serves as an IOL power verification process by providing aphakic measurements.
IA has demonstrated improved accuracy compared to preoperative biometry and is most beneficial in complex cases, including post-refractive surgery eyes, eyes with uncertainty in preoperative biometry, and cases involving premium and toric IOL implantation, which results in less postoperative residual astigmatism.
IA accuracy is highly dependent on meeting specific intraoperative conditions. Erroneous measurements can occur due to factors like eyelid squeezing, speculum pressure, eye position/fixation, abnormal eye pressure, media conditions (OVD type and refractive index), corneal status, small pupil size, and IOL specifics. Caution is recommended when IA readings disagree significantly with preoperative measurements (e.g., a vector difference of 0.5 D in cases of low astigmatism).
Conclusion: Intraoperative Aberrometry is beneficial, especially for eyes with abnormal axial length, prior refractive surgery, toric IOLs, multifocal lenses, or uncertain biometry. IA functions as an additional measurement and verification tool. While IA can be beneficial when the surgeon masters the technique and all variables are optimized, it could be a distraction if optimization is not met.
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Matteo PiovellaItaly
Speaker
Refractive cataract surgery to correct and eliminate presbyopia to achieve better vision in patients undergoing cataract surgerySynopsis Refractive cataract surgery is now replacing standard high-volume, low-cost cataract
surgery with monofocal IOL implantation. The possibility is to correct refractive defects, myopia,
hyperopia and astigmatism and overcome presbyopia limitations. It is necessary to change the
preoperative patient procedures and manage Meibomian gland dysfunction in cataract patients.
Normally three treatments should be applied: BlephEx (Alcon) to eliminate Demodex blepharitis
Biofilm and to open glands duct LipiFlow (J&J) to get postoperative refractive emmetropia. In this
course, we will review state-of-the-art knowledge on refractive cataract surgery in pursuing highly
satisfactory uncorrected distance, intermediate and near vision. Routine dry eye management will
be discussed. Advanced biometry, multiple shots and new procedures will be explained and
demonstrated .The new technical model for the adoption of refractive cataract surgery: biometry evaporative dry eye pupil-dependent trifocal IOLsSynopsis PRESENTATION will certify as postoperative precise IOL power detection is based on quality of
tear film to provide cornea smooth surface.Improvements . Multiple biometry exams are needed
until refractive IOLs power stabilization
Objective The MAPRY/clear oil protocol is based on consecutive session with three phisical
treatments. First treatment applied is Blephex(LLC) to remove Demodex, Biofilm and to unclog
excretory channels of the meibomian glands Second Treatment,LipiFlow (J&J),replaces occlusions
of the MG warming the material responsible of MGD improving a solid sttatification into the liquid
state easier to remove. ILux (Alcon)expels deeply from the meibomian glands the substances
responsible for their obstruction. The MAPRY protocol is based on one session per month at least
for 5 months, depending the grade and penetration ofhronic eyelids inflammation
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Burkhard DickGermany
Speaker
ESCRS Cataract Guidelines RecommendationsThe ESCRS Cataract Guidelines represent a comprehensive and evidence-based framework designed to support cataract surgeons across Europe in delivering safe, effective, and consistent care. In this presentation, an overview of the most relevant recommendations will be provided as well as key updates based on the latest clinical evidence.
Drawing from robust literature reviews and expert consensus, the ESCRS Guidelines cover the full patient journey: from preoperative assessment and biometry, to surgical technique, IOL selection, intraoperative considerations, and postoperative care. Emphasis will be placed on areas of evolving practice (SV IOL and infection prophylaxis).
Background will be given on how the guideline development process was designed to ensure practical relevance while maintaining scientific rigor, and how implementation can be supported across diverse healthcare settings. The goal is not only to standardize best practices but also to allow flexibility where justified by patient needs or surgical complexity.
This talk aims to provide attendees with clear, actionable insights from the ESCRS Cataract Guidelines that can enhance surgical outcomes and support continuous quality improvement in cataract care.IOL Exchange in the Premium IOL Era: Challenges and SolutionsThe rise of simultaneous vision intraocular lenses (SV IOLs), including multifocal, extended depth of focus, and toric designs, has significantly expanded visual outcomes in cataract and refractive surgery. However, this progress has been accompanied by an increase in the complexity and frequency of postoperative patient dissatisfaction, leading to a higher demand for IOL exchange in select cases.
This presentation explores the unique challenges of IOL exchange in the era of SV IOL technologies. Key indications for explantation will be reviewed, including suboptimal visual quality, dysphotopsia, residual ametropia, and rotational instability. Emphasis will be placed on clinical decision-making, diagnostic precision, and the timing of intervention, particularly in light of evolving patient expectations. Surgical strategies for safe and effective explantation will be discussed.
In addition, the importance of careful patient selection, preoperative counseling, and enhanced biometric planning as critical factors in reducing the need for IOL exchange will be highlighted. Emerging technologies that may support more accurate IOL selection and customization will also be briefly introduced.
This talk aims to provide practical guidance for surgeons facing the growing demands of managing SV IOL complications and achieving optimal outcomes through safe exchange procedures.
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Thomas KOHNENGermany
Speaker
Power and Precision: The New Era of Phacoemulsification TechnologyBridging Cornea and Lens: The Modern Role of Phakic IOLs in a Myopic WorldFrom Awareness to Action: Stepwise Learning to Manage Capsular Rupture During Cataract Surgery
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Justin SherwinAustralia
Speaker
Two Eyes, One Day: The Evolving Landscape of Immediate Sequential Cataract SurgeryImmediate bilateral sequential lens-based surgery is increasingly adopted as a safe, effective, and patient-centred option for cataract and lens-based refractive procedures. This presentation reviews recent evidence on epidemiology, practice patterns, and outcomes across cataract surgery, refractive lens exchange, and phakic IOL implantation.
Studies demonstrate high efficacy in achieving refractive targets, rapid recovery of binocular vision, and consistent improvements in quality of life. Advances in biometry, surgical technology, and IOL design have further enhanced predictability and safety. Safety remains central, with very low rates of bilateral complications when established risk-reduction protocols—separate instrumentation, asepsis, and adherence to guidelines—are followed.
Comparisons with delayed sequential surgery show equivalent visual and refractive outcomes, along with reduced healthcare burden. This session will highlight current evidence on efficacy, safety, visual and refractive outcomes, and patient-reported benefits, while considering future directions in the expanding role of immediate bilateral sequential lens-based surgery.
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Pannet PangputhipongThailand
Speaker
Phacoemulsification: Challenging and Interesting CasesPhacoemulsification in complex cases is always challenging. Situations such as hard nucleus, intumescent cataract, posterior polar cataract, loose zonule, or small pupil require special surgical techniques to overcome the difficulties. In some patients, multiple complexities may occur simultaneously, making the procedure extremely challenging—sometimes described as a surgeon’s nightmare.
This presentation will highlight selected interesting cases and demonstrate strategies to manage them safely, guiding surgeons on how to navigate through these “war zone” scenarios with confidence.Challenges in Soft Nucleus: Don’t Drown in Shallow WaterPhacoemulsification in soft nuclei can be challenging if inappropriate techniques are used. The soft nature of the nucleus makes nuclear disassembly difficult. Chopping and rotation are not easily performed because the chopper tends to cut through the nuclear mass when cracking or rotational force is applied, without achieving satisfactory results. The phaco tip also cannot hold the nucleus firmly enough during chopping or pulling.
“Stab Test” using a 27g. hydrodissection canular to determine the hardness of the nucleus before performing hydrodissection is essential, in order to choose the most appropriate phaco technique.
Special techniques such as Hydro Subluxation + Aspiration, Hydro Subluxation + Flip & Chop, Half Bowl + Rim Aspiration, and Chip & Flip (I. Howard Fine) will be discussed, including phacodynamics for soft nuclei.
When proper techniques are applied, surgery can be performed safely and effectively.
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Marco FantozziItaly
Speaker
Intracorneal Implants in the Cataract Age: Expanding Vision Beyond LensesIntracorneal Implants in the Cataract Age: Expanding Vision Beyond Lenses
Introduction:
Intracorneal implants were developed as an additive, minimally invasive, and removable approach to address presbyopia and loss of accommodation. Designed to complement rather than replace existing ocular structures, they can be used in near-emmetropic eyes or combined with laser refractive procedures and monofocal intraocular lenses (IOLs) for pseudophakic patients. This study aimed to evaluate the long-term outcomes of combined cataract surgery and intracorneal microlens implantation
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許粹剛 Tsui-Kang HsuTaiwan
Speaker
When the Capsule Gives Way: Winning the Posterior Rupture BattleCataract surgery is the most commonly performed operation in ophthalmology and despite tremendous instrumental and technological advancements, posterior capsular rupture (PCR) still occurs. PCR occurs both in all eye surgeons, although with a higher frequency in the newer starter group. Additionally, certain types of cataracts are prone to this development. If handled properly in a timely method, the eventual outcome may be no different from that of an uncomplicated case. However, improper management may lead to serious complications with a higher incidence of permanent visual impairment. The speech disclose the management of PCR from two perspectives: 1. Identifying patients with higher risk and know the sign of early PCR, and measures to manage such patients by surgical maneuver, and 2. Intraoperative management of posterior capsular rupture with anterior vitrectomy with different setting and various case scenarios to prevent further long-term complications. Solution for Residual Large Lens Material with PCRCompromise of the posterior capsule can occur in the hands of both new and experienced surgeons. Learning how to prevent, avoid, or efficiently manage posterior capsular rupture (PCR) is important. If PCR is present with residual lens material and vitreous loss, it is important to disentangle the vitreous from any nuclear/cortical fragments to ensure their safe removal without creating vitreous traction in case of retinal detachment. The vitreous can be stained by using preservative-free triamcinolone to delineate its presence in the anterior chamber and any incarceration in the wound. Anterior vitrectomy can be performed to remove the vitreous from the anterior segment properly. Alternatively, suppose the surgeon is comfortable with a pars plana approach which is better route. In that senario, a pars plana vitrectomy can be done, which helps to pull the vitreous back to the posterior segment, and avoids excessive anterior chamber manipulation. The pars plana approach may also permit better access to residual lens material—the vitrector may be used to clear nuclear and cortical material with a change in settings. At the end of the case, the wounds should be checked carefully to ensure no vitreous is present. A suture or more if necessary, depending on wound size, should be placed at the primary wound. Pupillary miosis should be done to inspect the pupil. If the pupil is peaked, there is likely vitreous still present in the anterior chamber and possibly in the wound. Once the vitreous is adequately cleared, one may carefully resume phacoemulsification and insert an IOL in various methods.
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許詠瑞 Yung-Ray HsuTaiwan
Speaker
Loose Zonules, Steady Hands: Saving the Unstable LensZonular dehiscence with vitreous prolapse represents one of the most challenging scenarios in cataract surgery. This case involves a 65-year-old female referred intraoperatively for severe temporal zonular dialysis extending 120° with vitreous prolapse into the anterior chamber.
In such situations, initial management options depend on the degree of capsular support and the surgeon’s familiarity with the anterior or posterior segment approaches. Possible options include: (1) primary pars plana lensectomy and vitrectomy (PPLV) with Yamane double-needle intrascleral fixation of an IOL; (2) anterior vitrectomy with in-the-bag or supplemental scleral fixation of a one-piece IOL using sutures; (3) pars plana vitreous levitation–assisted phacoemulsification; or (4) use of hooks or rings to preserve capsular support for in-the-bag implantation.
In this case, I stabilized the anterior capsule using iris retractors, performed a careful anterior vitrectomy, and completed a slow-motion phacoemulsification to minimize zonular stress. Following cortical cleanup, both an in-the-bag IOL and capsular tension ring (CTR) were successfully implanted. The patients visual acuity on postoperative day 1 was 0.9.
This surgical video illustrates a practical surgical maneuver with controlled movements, vitreous management, and structural stabilization techniques that allow safe phacoemulsification even in the setting of profound zonular loss.Pattern and Distribution of Uveitis Etiologies in Taiwan: A Multi-Center Perspective Uveitis is a heterogeneous group of intraocular inflammatory disorders with diverse etiologies and variable regional patterns. To delineate the current epidemiologic landscape of uveitis in Taiwan, a nationwide multicenter retrospective study was conducted collaboratively by the Taiwan Ocular Inflammation Society. Newly diagnosed uveitis cases from July 2022 to June 2023 were collected from 15 tertiary referral centers across northern, central, southern, and eastern Taiwan.
A total of 1,654 cases were analyzed. The mean age at onset was 49.5 ± 18.3 years, with nearly equal sex distribution (50.6% male). Anatomical classification includes anterior uveitis (64.3%), followed by panuveitis (22.4%), posterior uveitis (11.0%), and intermediate uveitis (2.3%). Etiologically, 43.6% were non-infectious, 23.5% infectious, and 32.9% undifferentiated. The leading non-infectious entities were HLA-B27/ankylosing spondylitis–related uveitis (15.4%), glaucomatocyclitic crisis (5.0%), and Vogt-Koyanagi-Harada syndrome (3.3%). Among infectious causes, herpetic anterior uveitis (7.7%), cytomegalovirus anterior uveitis (5.1%), and endogenous bacterial endophthalmitis (3.9%) predominated.
This large-scale multicenter study represents the most comprehensive epidemiological overview of uveitis in Taiwan to date. The unique disease pattern and relevant diagnostic challenges will be analyzed in this talk.
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王孟祺 Meng-Chi WangTaiwan
Speaker
Blinded by White: Cracking the Mature Cataract Safely (Presentation and Discussion)This is an unusual white cataract with posterior synechiae and silicone oil in the vitreous cavity following previous retinal detachment surgery.Before starting the procedure, we noticed some emulsified silicone oil at the apex of the anterior chamber.I injected trypan blue through the side port to stain the anterior capsule, followed by OVD injection from the opposite angle to replace and remove the dye as well as the silicone oil.After using a flat needle to separate the posterior synechiae, four iris hooks were placed to enlarge the small, fixed pupil. Unfortunately, the initial staining was insufficient, so I performed a second capsule stain.At this point, wrinkles and fibrosis over the anterior capsule were noted, so I decided to use an MVR blade to create the initial cut for the CCC.The anterior capsule had thickened significantly, making it hard to tear. After several unsuccessful attempts to tear the anterior capsule with the CCC forceps, I switched to microscissors to complete the capsulorhexis as round as possible.Regrettably, it was not possible to complete the capsulorhexis on the opposite side, so I attempted to use the CCC forceps once more. Fortunately, I was finally able to complete the capsulorhexis, although it was quite small and irregular. Since the anterior capsule was quite thick, I was not concerned about causing a radial tear during hydrodissection.It was quite easy to rotate the nucleus afterwards.Since the nucleus was rock-hard, I attempted to use the stop-and-chop technique, initiated by a long and deep sculpting.If the sculpting is not deep enough, it will be difficult to crack and completely bisect the hard nucleus.Take your time and spread your phaco tip and second instrument along the trench, section by section.Afterwards, rotate the nucleus 90 degrees away. At the same time, the milkified cortex was floating outside the capsule.I buried the phaco tip as deep as possible into the center of the nucleus. This allowed me to hold the nucleus firmly and chop it vertically without detaching it from the phaco tip.After cracking the nucleus into smaller pieces, I was able to manage each piece within the central pupillary area safely and efficiently.It is important to separate the leathery tethering part of the posterior pole completely; otherwise, it will be difficult to keep the nucleus pieces under control. If you follow this principle and take your time, you will be able to complete emulsification safely and effectively within the limited space, with a CDE of only 18.77. Another surprise emerged after I cleaned the nucleus: I found a large central fibrotic plaque on the posterior capsule, with nearly no epinucleus or cortex remaining. Silicon oil was shiny behind the posterior capsule.In this situation, it’s impossible to perform primary posterior continuous curvilinear capsulorhexis (CCC); therefore, I decided to use a YAG laser to open the posterior capsule one month later.Following the injection of OVD into the capsular bag, an aspheric hydrophobic intraocular lens (IOL) was implanted smoothly.After removing the iris hooks, I used micro scissors to trim the redundant tags from the CCC margin.The entire procedure was completed with stroma hydration for the main wound and all side ports. We could notice the dense fibrotic plaque over the central axis during the slit lamp examination the day after surgery. However, the central visual axis could still become clear after YAG capsulotomy, and fundus photography could be taken beautifully.
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林純如 Chun-Ju LinTaiwan
Speaker
Post-Op Red Flag: Beating Inflammation or Infection?Cataract surgery is one of the most frequently performed ophthalmic procedures and is generally associated with excellent visual outcomes. However, postoperative inflammation or infection can still lead to serious complications if not promptly recognized and managed. Distinguishing routine postoperative inflammation from sterile hyper-inflammatory reactions or early infectious endophthalmitis remains a clinical challenge. Importantly, reviewing the patient’s past medical and ocular history is essential, as underlying conditions such as uveitis, autoimmune disease, or prior ocular surgeries can significantly increase the risk and severity of postoperative inflammatory responses. Typical postoperative inflammation usually presents within the first few days and responds effectively to topical corticosteroids and nonsteroidal anti-inflammatory medications. In contrast, red flag signs—such as severe ocular pain, rapid vision decline, hypopyon, fibrin formation, or marked anterior chamber reaction—should raise suspicion for infectious endophthalmitis and prompt urgent intervention. Risk factors including wound leak, retained lens fragments, vitreous loss, or systemic immunosuppression further heighten concern. When media opacity limits direct examination, imaging tools such as anterior segment OCT and B-scan ultrasonography may assist diagnosis. Additionally, evidence supports tailored anti-inflammatory regimens perioperatively. Early recognition, patient education regarding warning symptoms, and timely referral to specialized care are critical in preventing irreversible visual loss. By identifying subtle clinical cues and considering patient-specific risk factors, ophthalmologists can effectively differentiate inflammation from infection and safeguard postoperative visual outcomes.
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許聖民 Sheng-Min HsuTaiwan
Speaker
Pseudophakic Macular Edema: Stopping Vision Loss Before It StartsPseudophakic macular edema (Ervine-Gass syndrome) remains the most common cause of decreased visual acuity after uneventful cataract surgery. Previous study reported that 26.8% of eyes with pseudophakic macular edema did not recover 6/6 vision. Clinically significant pseudophakic macular edema impairing patients' vision is found in 1-2% of patients with its peak 6 weeks following surgery, but subclinical macular edema can be seen in about 30% of patients in FA and up to 40% in OCT. To date, there are no uniform recommendations for the treatment of pseudophakic macular edema. Therefore, I will present two cases of pseudophakic macular edema here and discuss the strategies for treatment.
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蔡翔翎 Shawn TsaiTaiwan
Speaker
Get the Things Right: Correction of IOL SubluxationDislocation of an intraocular lens (IOL) is an uncommon (0.2–3%) yet potentially serious complication, in which the IOL deviates from its normal anatomical position. It may arise from complicated cataract surgery, ocular trauma, previous vitreoretinal surgery, high myopia, or systemic or ocular conditions associated with zonular weakness. While mild cases may be observed initially, surgical intervention is usually required when significant visual symptoms occur. Various surgical techniques can be employed depending on the surgeon’s experience and the clinical scenario. In this presentation, I will demonstrate two approaches: the “twist-and-out” IOL removal and the “Yamane technique” for secondary IOL fixation. The advantages, limitations, and practical considerations of these techniques will also be discussed.
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簡克鴻 Ke-Hung ChienTaiwan
Speaker
End the Bad Luck: Strategies for Refractive SurpriseDr. Chien will discuss the phenomenon of refraction surprise following cataract surgery—a postoperative outcome in which the patient’s refractive result differs from the intended target. Despite significant advancements in biometry technology, intraocular lens (IOL) power calculation formulas, and surgical techniques, refractive unpredictability can still occur and remains a noteworthy challenge in contemporary cataract surgery.
A variety of factors may contribute to refraction surprise, including inaccurate axial length measurement, corneal surface irregularities, posterior corneal astigmatism, unrecognized IOL tilt or decentration, and intraoperative issues such as capsular instability. Additionally, postoperative anatomical changes may further alter refractive outcomes.
Recognizing risk factors early and ensuring meticulous preoperative assessment are essential. When refraction surprise does occur, management options depend on both the underlying etiology and the magnitude of refractive deviation. Strategies include corneal refractive enhancement, piggyback IOL implantation, IOL exchange, or non-surgical approaches such as updating spectacles or contact lenses. Through case discussions and surgical experience sharing, Dr. Chien will present practical methods for preventing, diagnosing, and managing this complication—ultimately enhancing patient satisfaction and improving visual outcomes.
701C
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08:20
12:00
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孫興懷 Xinghuai SunChina
Speaker
Sustained drug-release glaucoma systems will replace eye drops"Glaucoma is a lifelong chronic disease, the only proven effective way to control glaucoma is lowering IOP, that’s an important pathological factor. In clinical, surgeries have effective, but not perfect. Eye drops still the keystone of anti-glaucoma treatment. But there are some limitations of anti-glaucoma drops with poor therapeutic benefits, like low aqueous humor bioavailability less 5%, lack of patient compliance, long-term IOP fluctuations with glaucoma progression, and with cumulative drug toxicity or adverse effects caused by drops active pharmaceutical ingredients and additives. So there are need improving therapeutic benefits following the ways like new dosage form/formulation, less relying on patient effort, sustained drug delivery all time and drug delivery with low dose. Sustained release glaucoma systems do much better than eye drops in delivering medications, so the greater therapeutic benefits and the better patient compliance could obtained. There are more and more clinical trials about sustained release systems for glaucoma. We introduced our some research results about lowering IOP sustained systems.
Sustained release system is a general development trend for glaucoma therapy, but most influenced by other two leading factors: out-of-pocket cost and interval between administrations. I think sustained release glaucoma systems will replace eye drops in the future."
Clinical Evaluation of Retinal Blood Flow in Glaucoma by OCTAFollowing the morphological structure of OCT, OCTA has contribute to the in-depth study of the mechanism of nerve damage and treatment evaluation in glaucoma. We have carried out clinical study of OCTA in glaucoma to quantify the peripapillary and parafoveal blood flow index and vessel density. The studies as the following aspects: At first, the POAG with early, middle, and late stages. These indices of blood flow index and vessel density in each stage of POAG gradually decreased. Results showed well diagnostic efficacy of blood flow index and vessel density for POAG. Then, we studied the eyes with acute attacks of PACG after one month when IOP controlled. Results showed the density of peripapillary vessels in PACG decreased significantly during the stages of chronic(PACG), attack(APAC), intermmitent(PAC) compared to preclinical (PACS) and normal controls. The vessel density in the macular area during chronic(PACG) stage is lower than that of normal controls. And we performed OCTA in the eyes before and 1 hour after LPI in 100 cases of PACS. Results indicated transient large IOP fluctuations have a greater impact on retinal blood flow. So, we think the glaucoma need a comprehensive treatment, in addition to lowering IOP, microcirculation should be improved, especially those with pre-existing retinal vascular disease.
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Chan Yun KIMKorea (Republic of)
Speaker
Minimally Invasive Bleb Surgery (MIBS): Redefining Safety and Efficacy in Glaucoma SurgeryMinimally Invasive Bleb Surgery (MIBS) represents a significant advancement in glaucoma treatment, combining the efficacy of traditional filtering procedures with the safety and simplicity of minimally invasive techniques. Devices such as the XEN Gel Stent, PreserFlo MicroShunt, and A-stream enable subconjunctival outflow with less tissue disruption.
This talk will review the core principles of MIBS, compare it with conventional surgery and MIGS, and highlight recent clinical outcomes. MIBS offers a promising surgical option for patients requiring effective intraocular pressure control with a lower risk profile.Advances in Contemporary Glaucoma Surgery: Innovations and Clinical ImpactThe field of glaucoma surgery has undergone remarkable transformation in recent years, driven by innovations aimed at improving efficacy, safety, and patient outcomes. This presentation will explore key advancements in surgical techniques, including the evolution of MIGS (Minimally Invasive Glaucoma Surgery), the emergence of MIBS (Minimally Invasive Bleb Surgery), and improvements in conventional filtering procedures.
Emphasis will be placed on how these innovations have influenced clinical decision-making, expanded surgical options across disease severity, and reshaped postoperative management. By examining current evidence and real-world outcomes, this talk aims to provide a comprehensive overview of the modern surgical landscape in glaucoma care and its practical implications for clinicians.
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張秀蘭 Xiulan ZhangChina
Speaker
How MIGS change the landscape of angle-closure glaucoma surgeryThis presentation aims to showcase the efficacy and safety of "minimally invasive" cataract-glaucoma and glaucoma surgeries in patients with primary open-angle glaucoma (POAG) and primary angle-closure glaucoma (PACG). Surgical videos and robust clinical evidence, including several multi-center studies conducted over the past five years, will be presented. Furthermore, recognition and evaluation from international experts, particularly within the Asia-Pacific region, will be summarized. These findings indicate an emerging trend toward cataract-glaucoma surgeries gradually replacing traditional phacotrabeculectomy procedures, and minimally invasive glaucoma surgery increasingly substituting trabeculectomy. Beyond introducing innovative surgical techniques, the presentation will also provide insights into effective clinical research design, innovation development, and strategies for successful translation into clinical practice.
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李飛 Fei LiChina
Speaker
Clinical Realities and Future Trends of Glaucoma AIArtificial intelligence (AI) is transforming glaucoma care, driving significant breakthroughs in screening, diagnosis, and risk assessment. This presentation will highlight recent advances in deep learning applied to fundus imaging, OCT, and visual field analysis, drawing on evidence from multicenter studies and real-world applications. Despite this rapid progress, major challenges remain—including data quality, limited interpretability, and barriers to integration into clinical practice. The talk will provide a detailed explanation of contemporary AI limitations and their underlying mechanisms, and will reflect on future directions to address these challenges. It will offer insights into both the potential and the limitations of current glaucoma AI, as well as practical steps needed to bridge the gap between research and real-world impact. Beyond clinical diagnosis and management, the presentation will also discuss the extended use of AI in glaucoma research, such as drug discovery and patient education.
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蘇乾嘉 Chien-Chia SuTaiwan
Speaker
Glaucoma Progression: What’s New and What’s MatterGlaucoma progression is typically evaluated using both functional and structural assessments. Visual field testing captures changes in field sensitivity, while imaging modalities such as OCT and OCTA provide detailed measurements of retinal ganglion cell and optic nerve structures. In this talk, I will review recent updates in monitoring glaucoma progression, including clustering strategies for visual field assessment, the influence of baseline values and floor effects on OCT parameters, and the comparative role of OCTA versus OCT in tracking disease progression.
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蕭雅娟 Ya-Chuan HsiaoTaiwan
Speaker
Functional Visual Impairment in Glaucomatous Visual Field DefectGlaucoma is the leading cause of irreversible blindness worldwide. Visual field defects resulting from optic nerve damage can impair peripheral awareness and interfere with daily functioning. This study aimed to evaluate the association between visual field loss and vision-related quality of life (VRQOL) in glaucoma patients.
A total of 73 patients (male: female = 34:39; mean age 60.53 ± 14.41 years) were enrolled. Mean intra-ocular pressure (IOP) was 13.77 ± 3.89 mmHg in the right eye and 13.98 ± 3.77 mmHg in the left eye. Vision-related quality of life was assessed using the validated Taiwanese version of the NEI VFQ-25(T). Visual field severity was quantified using mean defect (MD), pattern deviation (PD), and corrected pattern deviation (CPD). Patients reported substantial reductions in general health and general vision. Near-vision activities were more affected than distance-related tasks. Role difficulties and mild impairment in social functioning were also observed. Among the 30 respondents to driving-related items, mild functional limitations were noted but showed wide variability. Common daily-life challenges included reading difficulties, face recognition problems, shopping obstacles, limitations in electronic device use and public transportation, and fear of falling or using stairs.
These findings highlight the significant impact of visual field loss on functional independence in glaucoma. Rehabilitation strategies—such as reading aids or mobility-oriented interventions—should be tailored to address specific VRQOL deficits in patients with peripheral visual impairment.
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莊蘭馨 Lan-Hsin ChuangTaiwan
Speaker
Exploration of Normal Tension GlaucomaNormal-tension glaucoma (NTG) presents a unique clinical challenge: progressive optic neuropathy occurs despite intraocular pressures (IOP) within the statistically normal range. This talk explores current insights into the pathophysiology, diagnosis, and management of NTG, emphasizing emerging concepts that extend beyond traditional IOP-centric models of glaucoma care. Key mechanisms—including vascular dysregulation, impaired autoregulation, systemic hypotension, and translaminar pressure gradients contributing to optic nerve susceptibility—will be reviewed. Advances in imaging and functional testing that enhance early detection, particularly structural biomarkers identified through optical coherence tomography angiography, will also be discussed. Therapeutic strategies will be outlined, including IOP-lowering interventions and modification of systemic risk factors. In addition, we will examine the evolving understanding of the relationship between high myopia and NTG. Findings from our longitudinal study suggest that increased axial length may heighten optic nerve susceptibility, further informing individualized approaches to NTG management.
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趙世鈞 Shih-Chun ChaoTaiwan
Speaker
IOL Selection in Glaucoma PatientIn patients with both cataract and glaucoma, intraocular lens (IOL) selection is a critical decision that must balance visual enhancement with long-term disease stability. While premium IOLs—such as multifocal, extended depth of focus (EDOF), accommodative, toric, and aspheric lenses—offer advantages like improved spectacle independence and enhanced intermediate vision, their benefits must be weighed against the unique challenges posed by glaucomatous eyes.
Ultimately, IOL selection should be highly individualized. Patients with glaucoma suspect, ocular hypertension, or stable early glaucoma may benefit from certain types of premium lenses, while those with moderate-to-severe disease should prioritize visual quality and safety over spectacle independence. Other factors such as ocular surface disease, pupil reactivity, type of glaucoma surgery, and biometric stability must all be carefully considered to optimize outcomes.
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邱欣玲 Shin-Lin ChiuTaiwan
Speaker
Phacoemulsification Pearls in Angle-Closure GlaucomaPurpose:
Phacoemulsification in primary angle-closure glaucoma (PACG) is technically demanding because of shallow anterior chamber, poor pupil dilation, corneal edema, and zonular weakness. This presentation summarizes essential surgical pearls to optimize safety and efficacy in these challenging cases.
Methods:
Comprehensive surgical steps were reviewed, including preoperative intraocular pressure (IOP) control, intraoperative modifications, and postoperative care. Preoperatively, IOP should be reduced using topical β-blockers, α-agonists, CAIs, PGAs, and systemic dehydrating agents. During surgery, cohesive OVDs are used to deepen the anterior chamber and flatten the iris. A staged continuous curvilinear capsulorhexis (CCC) technique—with OVD refilling from the opposite side—prevents runaway rhexis. Low-fluidics phaco settings, gentle hydrodissection, and capsule tension rings are applied to maintain stability. Intraoperative goniosynechialysis using a spatula or bent needle can restore angle function after IOL implantation.
Results:
These refinements enhance visualization, prevent iris prolapse, reduce corneal stress, and maintain zonular integrity. Postoperatively, careful monitoring for IOP spikes, inflammation, or malignant glaucoma ensures smoother recovery and better IOP control.
Conclusions:
Successful phacoemulsification in PACG requires anticipation, chamber stability, and gentle fluidic control. With meticulous planning and adaptation to anatomic constraints, the procedure can achieve both visual improvement and long-term pressure reduction, offering a safe and effective surgical approach for angle-closure glaucoma patients.
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陳美如 Mei-Ju ChenTaiwan
Speaker
Navigating Challenges with Minimal Invasive Bleb Surgery for the Treatment of GlaucomaThe XEN gel implant is a subconjunctival minimal invasive minimal invasive device of bleb-forming glaucoma surgical procedure. It was developed with the aim of improving the predictability and safety profile with good stability and biocompatibility. This device has demonstrated promising outcomes with fewer risks compared to traditional surgeries. However, challenges still prevail with techniques of implantation, postoperative needling and complications. The talk will address different surgical techniques of implantation and bleb management.
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701E
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林慧茹 Hui-Ju LinTaiwan
Moderator
Advances in Artificial Intelligence Models and Algorithms in Amblyopia and Strabismus Review of Artificial Intelligence (AI) models that detect strabismus and amblyopia risk factors from smartphone photos, videos, and images, facilitating large-scale, accessible community screening. Discussion on how AI is personalizing amblyopia therapy, thereby maximizing efficacy and engagement. Critical appraisal of the requirements for clinical validation, regulatory approval, and the ethical integration of these AI tools into standard ophthalmic practice.
AI is poised to fundamentally reshape the management of strabismus and amblyopia by introducing unprecedented levels of objectivity, accessibility, and personalization. the knowledge to understand, evaluate, and eventually integrate these powerful technologies into their practice to improve patient outcomes. AI screening and diagnosis to treatment optimization and monitoring.
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蔡忠斌 Chong-Bin TsaiTaiwan
Speaker
Could Botulinum Toxin Be an Effective Primary Treatment for Infantile Esotropia?Introduction: To report the long-term success rate of botulinum toxin as the primary treatment for infantile esotropia. Methods: A single-center, retrospective review examined botulinum toxin use in children with esotropia onset before 12 months and presented by age 48 months. Success was defined as ocular alignment within 10 prism diopters (PD) of orthotropia. Results: A total of 35 children received botulinum toxin as primary treatment (1 injection: 63%; 2 injections: 17%; 3 injections: 14%; 4 injections: 6%). Of these, 20 (57%) had only botulinum toxin (BT group), while 15 (43%) had both botulinum toxin and surgery (BT+OP group). The mean deviation at initial presentation was 46.5 ± 13.8 PD in the BT group and 47.3 ± 11.3 PD in the BT+OP group. The mean age for initial botulinum toxin treatment was 1.8 ± 0.8 years for the BT group and 1.5 ± 0.8 years for the BT+OP group. The average follow-up time was 37.3 ± 22.6 months for the entire group. The success rate was 75% (15 of 20) for the BT group and 53% (8 of 15) for the BT+OP group, with no significant difference in success rates between the groups. Conclusions: Botulinum toxin demonstrated a notable long-term success rate as a primary treatment for infantile esotropia. These findings suggest botulinum toxin is an effective initial treatment option, with sustained results observed over an average follow-up of over three years.
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王安國 An-Guor WangTaiwan
Speaker
Upshooting Eye After TED IR Myectomy: How Do We Manage? Two TED patients received IR myectomy for hypotropoia. They developed upshooting eyes with severe limitation of infraduction postoperatively. We collaborated with ENT surgeon using endoscopic surgery with navigation system to identify the proximal stump of IR, and repair with non-absorbable suture. Both patients recovered their binocular vision after the operation.
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Zia ChaudhuriIndia
Speaker
High-Resolution Orbital MRI in strabismus and myopia: A Fascinating Journey of DiscoveryMagnetic resonance imaging (MRI) provides in vivo visualization of the static and dynamic configuration of extraocular muscles (EOM) and their connective tissues, aiding delineation of their anatomy and physiological functions. Defining the normal is of relevance because it aids extrapolation of the abnormal, which has translational relevance for the appropriate diagnosis and management of strabismus. This evaluation has also been found to be of high informative relevance in myopia, which has assumed pandemic stature in the east Asian population and now, also in the south Asian population. In addition, high-resolution surface coil orbital MRI techniques with suitable positioning of the eyeballs in different target-controlled positions aids knowledge of the actions of EOMs in different positions of conjugate gaze, as well as during convergence at near. Dr Chaudhuri was trained in the acquisition and analysis of these high-resolution orbital images in strabismus under the direct supervision of Prof Joseph Demer at JSEI, UCLA and has subsequently continued this research in India, thus making her an investigator from both sides of the ocean, so to say, and in different ethnic populations. This presentation will specifically provide an overview of high-resolution, surface-coil orbital MRI of the EOMs and ocular adnexa with due emphasis on congenital and acquired strabismus and myopia, including the enigmatic condition of myopic anisometropia, where despite similar genetics and environment, the two eyes grow asymmetrically.
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Stephen KraftCanada
Speaker
Adult Strabismus Surgery: Do Adjustable Sutures Increase the Success of Surgery?Studies comparing strabismus surgical cases using adjustable sutures (AS) to non-adjustable procedures (NA) have focused on the rate of re-operations as well as the alignment results. The majority of the articles, encompassing hundreds of patients, show that AS improve success from both the reoperation rate and alignment aspects. However, systematic reviews point out that prospective controlled studies are lacking, and so conclusions cannot be drawn about the effectiveness of AS.
This presentation will provide a brief review of the main articles in the literature comparing success rates with AS versus NA cases, as well as the five goals of an eye muscle operation. Following this introduction, the talk will illustrate the technique the author uses for his AS. Finally, the author will present three lines of evidence confirming the improved alignment success of using AS versus NA cases. This evidence derives from his over 40 years of experience and which is published in several articles from his centre.
It is hoped that after this presentation, both novice and experienced strabismus surgeons will feel comfortable incorporating AS into their cases. They will also understand that the additional time and effort in using AS will be justified in improving the success rate of their surgery.Pearls and Tips from 43 Years in StrabismologyIn addition to a careful history, a complete strabismus evaluation involves careful measuring of the alignment in the diagnostic gaze positions and noting the eye muscle actions in the cardinal positions of gaze. The prism measurements and the eye movement gradings must be consistent with each other, so that an appropriate differential diagnosis can be developed. A good refraction is also a vital component of the work-up.
This presentation comprises a selection of pearls and tips learned and applied over several decades in the author’s strabismus practice. These tips have helped improve diagnostic skills as well as treatment of both basic and advanced strabismus cases. These items will be discussed in 3 categories: diagnostic testing, non-surgical management, and surgical management.
Some items are referenced in various sources, while others have not, to the presenter’s knowledge, been published before.
At the end of each section, the specific pearl(s) for the audience will be noted as well as the application of that information. It is hoped that these tips will prove useful for novice as well as seasoned strabismus practitioners.
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蔡忠斌 Chong-Bin TsaiTaiwan
Moderator
Could Botulinum Toxin Be an Effective Primary Treatment for Infantile Esotropia?Introduction: To report the long-term success rate of botulinum toxin as the primary treatment for infantile esotropia. Methods: A single-center, retrospective review examined botulinum toxin use in children with esotropia onset before 12 months and presented by age 48 months. Success was defined as ocular alignment within 10 prism diopters (PD) of orthotropia. Results: A total of 35 children received botulinum toxin as primary treatment (1 injection: 63%; 2 injections: 17%; 3 injections: 14%; 4 injections: 6%). Of these, 20 (57%) had only botulinum toxin (BT group), while 15 (43%) had both botulinum toxin and surgery (BT+OP group). The mean deviation at initial presentation was 46.5 ± 13.8 PD in the BT group and 47.3 ± 11.3 PD in the BT+OP group. The mean age for initial botulinum toxin treatment was 1.8 ± 0.8 years for the BT group and 1.5 ± 0.8 years for the BT+OP group. The average follow-up time was 37.3 ± 22.6 months for the entire group. The success rate was 75% (15 of 20) for the BT group and 53% (8 of 15) for the BT+OP group, with no significant difference in success rates between the groups. Conclusions: Botulinum toxin demonstrated a notable long-term success rate as a primary treatment for infantile esotropia. These findings suggest botulinum toxin is an effective initial treatment option, with sustained results observed over an average follow-up of over three years.
王安國 An-Guor WangTaiwan
Moderator
Upshooting Eye After TED IR Myectomy: How Do We Manage? Two TED patients received IR myectomy for hypotropoia. They developed upshooting eyes with severe limitation of infraduction postoperatively. We collaborated with ENT surgeon using endoscopic surgery with navigation system to identify the proximal stump of IR, and repair with non-absorbable suture. Both patients recovered their binocular vision after the operation.
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Stephen KraftCanada
Speaker
Adult Strabismus Surgery: Do Adjustable Sutures Increase the Success of Surgery?Studies comparing strabismus surgical cases using adjustable sutures (AS) to non-adjustable procedures (NA) have focused on the rate of re-operations as well as the alignment results. The majority of the articles, encompassing hundreds of patients, show that AS improve success from both the reoperation rate and alignment aspects. However, systematic reviews point out that prospective controlled studies are lacking, and so conclusions cannot be drawn about the effectiveness of AS.
This presentation will provide a brief review of the main articles in the literature comparing success rates with AS versus NA cases, as well as the five goals of an eye muscle operation. Following this introduction, the talk will illustrate the technique the author uses for his AS. Finally, the author will present three lines of evidence confirming the improved alignment success of using AS versus NA cases. This evidence derives from his over 40 years of experience and which is published in several articles from his centre.
It is hoped that after this presentation, both novice and experienced strabismus surgeons will feel comfortable incorporating AS into their cases. They will also understand that the additional time and effort in using AS will be justified in improving the success rate of their surgery.Pearls and Tips from 43 Years in StrabismologyIn addition to a careful history, a complete strabismus evaluation involves careful measuring of the alignment in the diagnostic gaze positions and noting the eye muscle actions in the cardinal positions of gaze. The prism measurements and the eye movement gradings must be consistent with each other, so that an appropriate differential diagnosis can be developed. A good refraction is also a vital component of the work-up.
This presentation comprises a selection of pearls and tips learned and applied over several decades in the author’s strabismus practice. These tips have helped improve diagnostic skills as well as treatment of both basic and advanced strabismus cases. These items will be discussed in 3 categories: diagnostic testing, non-surgical management, and surgical management.
Some items are referenced in various sources, while others have not, to the presenter’s knowledge, been published before.
At the end of each section, the specific pearl(s) for the audience will be noted as well as the application of that information. It is hoped that these tips will prove useful for novice as well as seasoned strabismus practitioners.
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莊怡群 Ann Yi-Chiun ChuangTaiwan
Moderator
Small-Optical-Zone Ortho-K in Myopia Control 小光心角膜塑型片於近視控制中的應用Orthokeratology (Ortho-K) represents the foundation of modern optical myopia control through the induction of peripheral myopic defocus. Subsequent optical interventions, including myopia-control spectacle and soft contact lenses, were developed based on the same principle. A newer advancement in this field is the small-optical-zone overnight Ortho-K design, exemplified by the myOK-pro lens. This approach preserves the advantages of conventional Ortho-K while enhancing myopia-control efficacy by reducing the central treatment zone to generate greater peripheral myopic defocus.
Traditional Ortho-K tends to provide stronger control in higher prescriptions, whereas low-myopia patients often experience limited defocus and consequently weaker outcomes. For children who are unsuitable for or unwilling to wear spectacles or soft lenses, this presents a therapeutic gap. Small-optical-zone designs aim to address this need by improving defocus magnitude for low-myopia patients. However, simply reducing the optical zone in older designs may increase visual disturbances such as flare and halo. Modern small-optical-zone lenses seek to overcome these limitations, offering optimized visual quality alongside improved myopia-control performance.
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林慧茹 Hui-Ju LinTaiwan
Speaker
Advances in Artificial Intelligence Models and Algorithms in Amblyopia and Strabismus Review of Artificial Intelligence (AI) models that detect strabismus and amblyopia risk factors from smartphone photos, videos, and images, facilitating large-scale, accessible community screening. Discussion on how AI is personalizing amblyopia therapy, thereby maximizing efficacy and engagement. Critical appraisal of the requirements for clinical validation, regulatory approval, and the ethical integration of these AI tools into standard ophthalmic practice.
AI is poised to fundamentally reshape the management of strabismus and amblyopia by introducing unprecedented levels of objectivity, accessibility, and personalization. the knowledge to understand, evaluate, and eventually integrate these powerful technologies into their practice to improve patient outcomes. AI screening and diagnosis to treatment optimization and monitoring.
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蔡紫薰 Tzu-Hsun TsaiTaiwan
Speaker
Facts and Myths: What We Need to Know About Atropine Eye DropsA study conducted in Taiwan during the 1990s demonstrated that atropine reduced myopia progression in a dose-dependent manner. Since that time, the clinical use of atropine in school-aged children has been widespread in Taiwan for more than two decades. Owing to this long history of high-concentration atropine prescriptions, Taiwan represents a distinctive setting in which to evaluate the long-term safety of atropine use. Using data from a large cohort within the NHIRD, we found that the incidence of ocular complications was higher among individuals with myopia compared with those without. However, among participants with myopia, the incidence of these complications did not differ between atropine users and nonusers, and higher cumulative doses of atropine were not associated with increased risk.
The long-term efficacy of atropine eye drops for myopia control also merits further investigation. The LAMP clinical trial demonstrated that continuous treatment with 0.05% atropine effectively controlled myopia progression over five years. In contrast, the ATLAS from Singapore reported that topical atropine use during childhood was not associated with long-term ocular complications; however, its long-term efficacy in myopia control was less conclusive. Furthermore, recent randomized clinical trials have yielded inconsistent findings regarding the effectiveness of low-dose atropine, and regulatory approval by the U.S. FDA remains pending. Further research is therefore warranted to refine atropine treatment strategies, including the optimal timing of initiation, adjustment of concentration, duration of therapy, and methods and timing of discontinuation. Most importantly, future work should aim to clarify the ultimate clinical significance and long-term benefits of atropine therapy for myopia control.
接軌國際：IMI 近視前期定義與台灣經驗分享Pre-myopia is an emerging concept in myopia prevention, referring to children within a specific age range who exhibit refractive errors that, along with certain risk factors, place them at increased risk of developing myopia and who may benefit from early intervention. This presentation focuses on the international definitions of pre-myopia and utilizes public health survey data and clinical evidence from Taiwan to analyze the prevalence of pre-myopia and explore issues related to myopia development.
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彭智培 Calvin PangHong Kong, China
Speaker
Genomic investigations on the progression of childhood myopiaCalvin CP Pang彭智培
Department of ophthalmology and visual sciences, The Chinese University of Hong Kong, Hong Kong, China
Myopia, the commonest ocular disorder in most populations estimated to affect a half of the world’s population in 2050, is prevalent and serious in East Asians with a steep rising trend in Caucasian and other Asian populations. More than 200 associated loci spreading all chromosomes are associated with myopia. While children of myopic parents across most populations are more prone to develop myopia, lifestyles in near work and outdoor time also cast strong influence. After onset of myopia, progression is different among children. In our cohorts of Chinese trio families, school children at different severities, and children receiving atropine, we conducted whole genome association studies (GWAS) and whole exome sequencing (WES) to investigate genetic loci in association with myopia progression based on quantitative traits, myopia progression over 3 years and lifestyle parameters. Based on our three stage GWAS of children myopia, there are associations of scleral equivalent and axial length with SNPs in MIR4275, LOC101928911, TENM3 and FAM135B. We calculated children’s genetic risk score (GRS) and found myopia severity increased with both near work and GRS levels, higher GRS showed a greater decrease in SE with the same amount of near work. More genomic information will be revealed as our data analysis continues.
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701F
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蔡悅如 Yueh-Ju TsaiTaiwan
Moderator
Transcanalicular Diode Laser Assisted DacryocystorhinostomyTranscanalicular laser dacryocystorhinostomy is a minimally invasive surgical intervention for nasolacrimal duct obstruction. The procedure involves creating a direct osteotomy by advancing a laser fiber through the canaliculus to ablate the bone and soft tissue separating the lacrimal sac from the nasal cavity. This approach offers distinct advantages, including the absence of cutaneous scarring, superior hemostasis, and preservation of the physiological lacrimal pump mechanism; it also serves as an effective salvage technique for failed DCRs. We utilized an 810-nm diode laser, and a video demonstration of the intraoperative technique will be presented. Due to the reduced operative time and minimal bleeding, this procedure is well-suited for local anesthesia, making it particularly advantageous for elderly patients.
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胡佩欣 Pei-Shin HuTaiwan
Speaker
Nonspecific Orbital Inflammation UpdateNonspecific orbital inflammation (NSOI) remains one of the most challenging diagnostic entities in orbital disease due to its heterogeneous presentation and overlap with infectious, autoimmune, and neoplastic conditions. Traditionally considered a diagnosis of exclusion, NSOI now benefits from emerging imaging criteria, structured diagnostic algorithms, and increasing evidence supporting individualized management. This presentation integrates data from recent guideline development and a large evidence-based clinical cohort to provide a concise and practical framework for clinicians.
Key components include updated classification systems, the role of MRI with diffusion-weighted imaging in differentiating NSOI from lymphoma or IgG4-related disease, and indications for biopsy when clinical or radiologic features are atypical or treatment response is inconsistent. Treatment strategies emphasize corticosteroid response patterns, recurrence predictors, and escalation pathways incorporating immunosuppressants, biologics such as rituximab, and selective radiotherapy.
By combining high-level evidence with annotated imaging examples and treatment algorithms, this lecture aims to support accurate diagnosis, avoid misclassification, and improve long-term outcomes in patients with NSOI, especially those with recurrent or steroid-dependent disease.
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涂云海 Yunhai TuChina
Speaker
Endoscopic removal of orbital apex massThe orbital apex mass has always been a difficult point in orbital surgery. The anatomical space of the orbital apex is narrow, and transorbital surgery often leads to serious complications, even blindness. We have been committed to minimally invasive ophthalmic endoscopic surgery. Endoscopic transnasal surgery has opened up a new world for the removal of orbital apex tumors, and we gradually mastered the operation of dual instruments with both hands under endoscopy by one doctor. However, there is still no solution for the orbital apex mass upper lateral of the optic nerve . We designed a surgical approach combining endoscopic transnasal and transperiosteal space surgery. Starting from the foreign body in the orbital apex, continuous practice has been carried out to successfully remove the orbital apex mass upper lateral of the optic nerve. Thus, we have achieved a complete surgical system for endoscopic removal of orbital apex mass
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蔡傑智 Chieh-Chih TsaiTaiwan
Speaker
Computer-Assisted Navigation in Orbital SurgeryOrbital surgery presents unique challenges due to the complex anatomy of the orbit and the close proximity of vital structures such as the optic nerve and extraocular muscles. Traditional freehand approaches rely heavily on surgical experience and anatomical estimation, which can limit precision in complex orbital surgery. Computer-assisted navigation (CAN) has emerged as a transformative tool to enhance surgical accuracy, safety, and predictability.
This lecture will explore the principles and clinical applications of computer-assisted navigation in orbital surgery. Topics include image acquisition and 3D reconstruction, preoperative virtual planning, and real-time intraoperative guidance. Case examples will illustrate its use in orbital fracture repair, decompression for thyroid eye disease, and tumor excision. Patient-specific implants designed through advanced three-dimensional (3D) imaging, computer-aided design and computer-aided manufacturing will also be presented.
In conclusion CAN has bridged radiologic imaging and operative execution, providing a safer and more precise approach to orbital surgery.
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魏以宣 Yi-Hsuan WeiTaiwan
Speaker
Transforming TED Management: The Rise of Targeted Therapies and What the Evidence Tells UsTreatment for thyroid eye disease (TED) has changed greatly with the development of new targeted biologic therapies. Research on IGF-1R, IL-6, and other potential targets for biologic therapy has been extensive in recent years. This talk will review how these therapies work, summarize key clinical findings, and share real-world experience. By combining current evidence and clinical insights, we will explore how targeted treatments are improving outcomes and transforming the management of TED.
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Sarah CouplandUnited Kingdom
Speaker
Uveal melanoma prognostication: beyond chromosome 3Prognosis for uveal melanoma (UM) is determined by a combination of clinical, histopathological, and molecular factors. Clinical markers include tumour size and location, while histopathological factors include cell type and mitotic activity. The Liverpool Ocular Oncology Centre has a long track record in UM prognostication, and has devised an algorithm (LUMPO3) for more precise risk stratification and identifying patients at high risk for metastasis. It is a multiparametric model, which also included genetic data, particularly chromosome 3 and 8. It has been demonstrated that BAP1 immunohistochemistry is a very close surrogate for the status of the BAP1 gene, which if mutated is associated with a poor prognosis in UM. Our recent work has investigated the inclusion of BAP1 immunohistochemistry in LUMPO3, in labs where chromosomal analysis is not available. Early detection of metastatic UM is critical, as the prognosis is poor once widespread metastases develop. If detected earlier, surgical and newer immunotherapy options have been demonstrated to prolong survival.Decoding intraocular masqueradeIntraocular lymphomas can be divided into 3 main subtypes: primary vitreoretinal lymphoma (VRL), primary choroidal lymphoma, and secondary intraocular lymphoma. VRL is a rare but aggressive form of non-Hodgkin lymphoma that affects the eye. The most common subtype is a Diffuse large cell B-cell lymphoma (DLBCL), and displays a similar morphology, immuno- and genetic profile to the primary CNS lymphomas. Indeed, VRL can relapse in the CNS, and similarly CNSL can involve the eye. VRL often "masquerades" as chronic uveitis, making early and accurate diagnosis challenging but crucial for effective treatment and improved prognosis. In contrast, primary choroidal lymphoma is an indolent non-Hodgkin lymphoma similar to the Marginal Zone B-cell lymphomas of the ocular adnexa, and do not spread to the CNS. This lecture will provide an update about the biology, diagnostics and treatment of VRL and choroidal lymphomas. It will also provide examples of differential diagnoses to consider in vitrectomy specimens.Update of Ocular Adnexal LymphomasOcular adnexal lymphomas are most commonly non-Hodgkin lymphomas (NHL) that develop in the conjunctiva, eyelid, lacrimal gland, and orbit. The most common subtype is an extranodal marginal zone lymphoma (EMZL), which often presents as a painless, salmon-coloured lesion on the conjunctiva or as a mass causing symptoms like proptosis, double vision, or swelling in the orbit. Other common NHL of the ocular adnexa include follicular lymphomas, diffuse large cell B-cell lymphomas and mantle cell lymphomas. Treatment varies as per lymphoma subtype and requires joined-up assessment with the haematologists and radiologists. Typically treatment is local with low-dose radiation therapy being a standard option for localised disease, while systemic treatment may be used for more advanced cases. This lecture will provide an update about the biology, diagnostics and treatment of ocular adnexal lymphomas.
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盧葦 Wei LuChina
Speaker
Precise Repair of Complex Orbital FracturesZygomatic-orbito-maxillary fracture is a kind of complex orbital fracture with high morbidity, which can lead to severe physical dysfunction and deformity. The orbital mechanical environment has great influence on the fracture repair and reconstruction. If the internal fixation is not consistent with the mechanical environment after the reconstruction, it is easy to lead to complications such as poor fracture healing, implant deformation, malposition and even breakage, which not only bring trouble to patients, but also increase financial burden. This study developed finite element models of absorbable material and titanium material for repair and fixation, respectively. By applying a force of 120 N to the model to simulate the masseter muscle strength, the maximum stress and displacement of the repair materials and the fracture ends were measured. In discussing various models, the maximum stress values of absorbable and titanium materials are less than their yield strength, and the maximum displacement values of the titanium material and fracture end were less than 0.1 mm and 0.2 mm. The maximum displacement values of absorbable material and fracture end in incomplete zygomatic fracture and dislocation were less than 0.1 mm and 0.2 mm. While in the zygomatic complex complete fractures and dislocation, the maximum displacement values of the absorbable material and the fracture end exceeded 0.1 mm and 0.2 mm. In this study, the finite element biomechanical analysis method improved the operative success ratio of zygomatic-orbito-maxillary fracture and reduced postoperative complications, which provided a new research method and objective quantitative basis for the accurate treatment.
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Kyung In Woo
Speaker
Anatomical Nuances and Surgical Finesse in Asian Upper BlepharoplastyAsian upper blepharoplasty, in our experience, benefits significantly from a profound understanding of the unique anatomical characteristics that distinctly differ from those of Caucasian eyelids. This lecture will focus on the subtle anatomical variations in the Asian eyelid, emphasizing the critical role of meticulous preoperative analysis and planning in achieving successful and natural-looking results. We will delve into key anatomical elements, including hidden ptosis, variations in eyelid heaviness, and epicanthus.
Throughout this presentation, we aim to explore various surgical techniques specifically designed to meet the aesthetic expectations of Asian patients while maintaining functional stability. Furthermore, we will share some refined surgical finesse and considerations aimed at minimizing complications and maximizing natural outcomes. We will also share the practical strategies and techniques for addressing complications that can result from blepharoplasty.
This lecture is designed to provide insights for ophthalmologists seeking to enhance their anatomical knowledge and surgical proficiency in Asian upper blepharoplasty.
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蔡悅如 Yueh-Ju TsaiTaiwan
Speaker
Transcanalicular Diode Laser Assisted DacryocystorhinostomyTranscanalicular laser dacryocystorhinostomy is a minimally invasive surgical intervention for nasolacrimal duct obstruction. The procedure involves creating a direct osteotomy by advancing a laser fiber through the canaliculus to ablate the bone and soft tissue separating the lacrimal sac from the nasal cavity. This approach offers distinct advantages, including the absence of cutaneous scarring, superior hemostasis, and preservation of the physiological lacrimal pump mechanism; it also serves as an effective salvage technique for failed DCRs. We utilized an 810-nm diode laser, and a video demonstration of the intraoperative technique will be presented. Due to the reduced operative time and minimal bleeding, this procedure is well-suited for local anesthesia, making it particularly advantageous for elderly patients.
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吳淑雅 Shu-Ya WuTaiwan
Speaker
From Injections to the Operating Table: Surgical Management of Benign Essential Blepharospasm Benign essential blepharospasm (BEB) is an adult-onset focal dystonia characterized by involuntary spasms of the periocular muscles, resulting in forced eyelid closure. Because the pathogenesis of BEB remains unclear, current management primarily aims at symptomatic relief. Botulinum toxin injection remains the first-line therapy, while surgical intervention is considered for patients with poor response to injections, or for those with eyelid deformities secondary to blepharospasm.
Protractor myectomy can be performed as either a full or limited procedure. Currently, limited myectomy is preferred due to its superior cosmetic outcomes and lower complication rates. In addition, combining limited myectomy or eyelid corrective surgery with botulinum toxin injections can further optimize clinical outcomes.
Apraxia of eyelid opening (AEO) is characterized by the paradoxical co-contraction of the orbicularis oculi and levator palpebrae muscles, often necessitating surgical management. Surgical strategies may involve either a single-stage or a two-stage approach. I personally favor the two-stage approach, as performing all procedures simultaneously can be technically challenging due to a higher risk of bleeding and hematoma formation. Staging the procedures allows for adequate assessment of the initial surgical results and more precise planning of subsequent interventions.
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Bobby S. KornUnited States
Speaker
Spatial Computing and Augmented Reality in Oculoplastic Surgery: Reimagining the Surgical FieldThe emergence of spatial computing headsets like the Apple Vision Pro is reshaping surgical visualization and education. In oculoplastic surgery, where precision and anatomical complexity are paramount, these tools offer immersive, real-time access to imaging and anatomical overlays without disrupting surgical flow.
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林宣君 Shan-Jiun LinTaiwan
Speaker
Principles for Natural, Symmetric, and Reliable Double Eyelid SurgeryThe fundamental principle for a natural result is the replication of the native anatomical connection between the anterior and posterior lamellae. Common issues that can produce an unnatural appearance include direct skin-to-posterior lamella fixation after orbicularis oculi muscle (OOM) disruption. Achieving symmetry extends beyond basic consistency in width and suture tension; it requires advanced adjustments based on individual patient anatomy, including levator function, eyelid thickness, and globe position (e.g., enophthalmos or proptosis). Reliability is secured by creating a stable, non-shallow fold, ensuring appropriate skin tightness, and maintaining a clear anatomical view of structures like orbital fat and the levator muscle during the procedure. The presentation also addresses common challenges and pitfalls, including the difficulty of precise measurement on aging or lax skin, the importance of patient marking in a seated position to account for gravity, and the cautious preservation of functional tissues, such as the orbicularis oculi muscle (OOM) and orbital septum, to prevent complications like lagophthalmos and facilitate potential future revisions.
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701G
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白內障手術 Wet Lab 實作｜Wet Lab Practical Course-Cataract Surgery
703
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屈光手術 Wet Lab實作｜Wet Lab Practical Course-Refractive Surgery
六福萬怡 Courtyard by Marriott Taipei
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08:59
12:01
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鄭成國 Cheng-Kuo ChengTaiwan
Moderator
Full Thickness Macular Hole: TRS Consensus of Surgical ManagementTo establish a consensus for surgical management of full-thickness macular hole (FTMH) and macular hole retinal detachment (MHRD). The Taiwan Retina Society (TRS) invited nine experienced vitreoretinal surgeons from Taiwan to participate in questionnaire for surgical management of FTMH and MHRD based on Delphi methodology. Among the 49 items, 30 items (61.2%) reached strong consensus after 2 rounds. For FTMH, strong consensus included routine internal limiting membrane (ILM) peeling in all stages of FTMH, ILM flap in large holes ≥ 400 μm, ILM flap covering technique, small peeling area < 5 mm diameter, preservation of adherent epiretinal membrane in the flap if it cannot be separated from ILM, C3F8 as preferred tamponade for ILM peeling alone but not in the presence of ILM flap, post-operative facedown position, simple intravitreal gas injection for early persistent holes, use of pedicle flap or SWIFT for persistent holes in previously small area-peeled macula. For MHRD, strong consensus included the use of ILM flap, ILM flap covering technique, preservation of adherent epiretinal membrane if it cannot be separated from ILM, C3F8 as preferred tamponade, post-operative ace down position, no intentional subretinal fluid drainage during air-fluid exchange in small RD area within arcade, intraoperative use of adjuvants. Strong consensus achieved in a significant portion of key questions frequently encountered in the management of FTMH and MHRD. Recommendations from this Delphi study helps in decision making for clinical practice.
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黃德光 De-Kuang HwangTaiwan
Speaker
ERM: TRS Consensus of Surgical Indication and Surgical ManagementEpiretinal membrane (ERM) is common, yet the optimal timing and technique for surgery remain variably practiced. The Taiwan Retinal Society (TRS) convened a panel of experienced vitreoretinal surgeons to synthesize evidence and expert experience into practical consensus statements on surgical indications and management. The suggested clinical classification, evaluation, and surgical management (including timepoint and methods) were discussed during the meeting. All results and consensus will be showed in this presentation.
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鄭成國 Cheng-Kuo ChengTaiwan
Speaker
Full Thickness Macular Hole: TRS Consensus of Surgical ManagementTo establish a consensus for surgical management of full-thickness macular hole (FTMH) and macular hole retinal detachment (MHRD). The Taiwan Retina Society (TRS) invited nine experienced vitreoretinal surgeons from Taiwan to participate in questionnaire for surgical management of FTMH and MHRD based on Delphi methodology. Among the 49 items, 30 items (61.2%) reached strong consensus after 2 rounds. For FTMH, strong consensus included routine internal limiting membrane (ILM) peeling in all stages of FTMH, ILM flap in large holes ≥ 400 μm, ILM flap covering technique, small peeling area < 5 mm diameter, preservation of adherent epiretinal membrane in the flap if it cannot be separated from ILM, C3F8 as preferred tamponade for ILM peeling alone but not in the presence of ILM flap, post-operative facedown position, simple intravitreal gas injection for early persistent holes, use of pedicle flap or SWIFT for persistent holes in previously small area-peeled macula. For MHRD, strong consensus included the use of ILM flap, ILM flap covering technique, preservation of adherent epiretinal membrane if it cannot be separated from ILM, C3F8 as preferred tamponade, post-operative ace down position, no intentional subretinal fluid drainage during air-fluid exchange in small RD area within arcade, intraoperative use of adjuvants. Strong consensus achieved in a significant portion of key questions frequently encountered in the management of FTMH and MHRD. Recommendations from this Delphi study helps in decision making for clinical practice.
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李承雍 Cheng-Yung LeeTaiwan
Speaker
Classification and Management of Myopic Traction Maculopathy: A Consensus from the Taiwan Retina SocietyWith the increasing prevalence of myopia, myopic traction maculopathy (MTM) has become more frequently encountered and often requires surgical management. However, its definitions, classifications, and treatment strategies remain inconsistent. To address the lack of standardized classification and management strategies, a panel of vitreoretinal specialists from the Taiwan Retina Society convened to develop a practical consensus. After reviewing current evidence, six key questions and corresponding statements were formulated through structured discussion and voting among ten panelists. MTM was defined as maculoschisis or maculoschisis with foveal disruption, encompassing lamellar macular hole, full-thickness macular hole, and macular hole with retinal detachment, the latter regarded as the end stage. A classification integrating the extent of maculoschisis and the type of foveal pathology was proposed. The panel emphasized the role of multimodal imaging, including optical coherence tomography, fundus photography, axial length measurement, and visual function assessment, in diagnosis and follow-up. Full-thickness macular hole and macular hole with retinal detachment were considered clear surgical indications, whereas surgery for maculoschisis or lamellar macular hole may be appropriate when visual deterioration occurs. The consensus recommends fovea-sparing internal limiting membrane peeling (foveola-ILM non-peeling) and the inverted internal limiting membrane flap technique as effective surgical approaches.
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吳宗典 Tsung-Tien WuTaiwan
Speaker
Guidelines and treatment patterns for primary rhegmatogenous retinal detachments: Expert consensus and survey in Taiwan Retina SocietyRhegmatogenous retinal detachment (RRD) is a significant cause of vision loss and requires appropriate surgical intervention. There are several approaches available, including observation, laser demarcation, pneumatic retinopexy, scleral buckling, and pars plana vitrectomy, which are chosen based on patient condition, surgeon experience, and national health insurance policies. Despite the various options, there is still no consensus on the optimal intervention. To address this, the Taiwan Retina Society assembled an expert committee with 11 experienced retina specialists to review the current evidence and develop a guideline with seven recommendations for managing RRD patients. Additionally, a survey was conducted with six questions to assess treatment patterns in Taiwan, which included input from the expert committee and an open poll at the 2023 Congress of the Taiwan Retina Society. This report provides a comprehensive summary of the current knowledge and expert consensus on the treatment of RRD, discussing the characteristics of current approaches and providing an overview of current treatment patterns in Taiwan. These findings aim to provide ophthalmologists with the best possible treatment for RRD.
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吳宗典 Tsung-Tien WuTaiwan
Moderator
Guidelines and treatment patterns for primary rhegmatogenous retinal detachments: Expert consensus and survey in Taiwan Retina SocietyRhegmatogenous retinal detachment (RRD) is a significant cause of vision loss and requires appropriate surgical intervention. There are several approaches available, including observation, laser demarcation, pneumatic retinopexy, scleral buckling, and pars plana vitrectomy, which are chosen based on patient condition, surgeon experience, and national health insurance policies. Despite the various options, there is still no consensus on the optimal intervention. To address this, the Taiwan Retina Society assembled an expert committee with 11 experienced retina specialists to review the current evidence and develop a guideline with seven recommendations for managing RRD patients. Additionally, a survey was conducted with six questions to assess treatment patterns in Taiwan, which included input from the expert committee and an open poll at the 2023 Congress of the Taiwan Retina Society. This report provides a comprehensive summary of the current knowledge and expert consensus on the treatment of RRD, discussing the characteristics of current approaches and providing an overview of current treatment patterns in Taiwan. These findings aim to provide ophthalmologists with the best possible treatment for RRD.
陳珊霓 San-Ni ChenTaiwan
Moderator
Surgical techniques in the management of PDR: Taiwan ConsensusPars plana vitrectomy (PPV) is the main treatment modality for patients with severe diabetic retinopathy. With the development of systems for microincision, wide-angle viewing, digitally assisted visualization, and intraoperative optical coherence
tomography, contemporary PPV for diabetic retinopathy has been performed on a wider range of indications than previously
considered. In this article, we reviewed, in conjunction with our collective experiences with Asian patients, the applications
of new technologies for PPV in eyes with diabetic retinopathy and highlighted several important procedures and entities not
generally reiterated in the literature, in order for vitreoretinal surgeons to optimize their approaches when facing the challenges imposed by the complications in diabetic eyes.
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賴佐庭 Tso-Ting LaiTaiwan
Speaker
ROP: Consensus of Pediatric Retina GroupOBJECTIVE: Retinopathy of prematurity (ROP) is the leading cause of childhood blindness, particularly in preterm infants. In Taiwan, the absence of national guidelines and the variability in clinical practice have highlighted the need for locally adapted consensus recommendations. METHODS: An expert panel of eleven ophthalmologists from eight tertiary centers in Taiwan convened to develop a consensus on ROP management. Through a structured process that included key question formulation, systematic literature review, iterative discussion, and voting, the panel established consensus statements. Agreement was defined as >/=75% of panelists voting "agree" or "strongly agree" using a five-point Likert scale. RESULTS: Consensus recommendations were developed across three major domains: screening, treatment, and follow-up. For screening, the panel endorsed criteria commonly used in Taiwan-gestational age <32 weeks or birth weight <1500 g-but emphasized the need for population-based validation. Both anti-vascular endothelial growth factor (VEGF) agents and laser photocoagulation were recognized as acceptable first-line treatments for type 1 ROP, with individualized treatment decisions based on disease characteristics, anesthesia risk, and follow-up capacity. Guidelines were also established for the management of ROP reactivation, procedural protocols, and agent selection. For follow-up, the panel recommended extended surveillance after anti-VEGF therapy and outlined the criteria for identifying and monitoring persistent avascular retina. Follow-up schedules were proposed to detect long-term ocular and neurodevelopmental complications. CONCLUSIONS: This consensus provides updated evidence-based guidance for ROP care in Taiwan, addressing both traditional and emerging clinical challenges. These recommendations aim to standardize care practices while remaining adaptable to future research and evolving clinical needs.What Else Behind Diabetic Retinopathy Beside Anti-VEGF?Diabetic retinopathy (DR) has long been characterized as a microvascular disease, and anti-VEGF therapy remains one of the standard treatments for its sight-threatening complications. However, accumulating evidence demonstrates that DR is a complex neurovascular disorder in which neurodegeneration, oxidative stress, chronic inflammation, dysregulated cell death pathways, and impaired autophagy play central roles. Preclinical studies highlight early retinal neurodegeneration, glial dysfunction, and microglia-mediated inflammation as substantial contributors to DR development and progression, which might precede clinically visible vascular changes. Oxidative stress is another major driver, triggering mitochondrial injury, endothelial dysfunction, and aberrant programmed cell death—including apoptosis, pyroptosis, and necroptosis—which further accelerates neurovascular impairment.
A growing body of experimental work has explored therapeutic strategies beyond VEGF suppression. Antioxidants such as astaxanthin have been shown to restore autophagy and enhance Nrf2-mediated defense mechanisms in photoreceptors under high-glucose stress—findings demonstrated in our own studies. Similarly, targeting inflammatory pathways with agents such as fenofibrate or cilostazol has been shown to reduce inflammatory mediators, oxidative damage, and retinal apoptosis in diabetic models. Additional approaches, including fibroblast growth factor 1 treatment and interventions aimed at preventing high-glucose-induced cellular senescence, further underscore the multifaceted nature of DR pathophysiology.
Together, these insights suggest that DR extends far beyond vascular endothelial dysfunction, and effective long-term management may require therapies targeting oxidative stress, inflammation, neuroprotection, autophagy regulation, and metabolic resilience. This talk will review these emerging mechanisms and discuss future therapeutic perspectives that complement, rather than replace, anti-VEGF therapy.
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陳珊霓 San-Ni ChenTaiwan
Speaker
Surgical techniques in the management of PDR: Taiwan ConsensusPars plana vitrectomy (PPV) is the main treatment modality for patients with severe diabetic retinopathy. With the development of systems for microincision, wide-angle viewing, digitally assisted visualization, and intraoperative optical coherence
tomography, contemporary PPV for diabetic retinopathy has been performed on a wider range of indications than previously
considered. In this article, we reviewed, in conjunction with our collective experiences with Asian patients, the applications
of new technologies for PPV in eyes with diabetic retinopathy and highlighted several important procedures and entities not
generally reiterated in the literature, in order for vitreoretinal surgeons to optimize their approaches when facing the challenges imposed by the complications in diabetic eyes.
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許淑娟 Shwu-Jiuan SheuTaiwan
Speaker
Risk factors associated with sight threatening diabetic retinopathy (STDR) severity and progression in diabetes mellitus (DM) patientsPurpose: This study aims to examine factors associated with sight threatening diabetic retinopathy (STDR) severity and progression in diabetes mellitus (DM) patients. Specifically, we focus on the initial HbA1C at diagnosis, its change at ophthalmologic visit and medication adherence (MR).
Research Design and Methods: A prospective study involving 300 type II DM patients (≥20 years) was conducted from July 2022 to January 2024. MR was assessed using the Taiwanese version of the Morisky Medication Adherence Scale-8 (MMAS-8). DR progression was evaluated through a defined clinical scoring system. Statistical analyses included chi-square tests and logistic regression to examine the factors associated with STDR severity and progression.
Results: After excluding 122 patients for missing data, 178 participants were analyzed. Changes in HbA1c were strongly associated with STDR. Both improvements and deteriorations or sustained high in HbA1c levels were linked to an increased likelihood of advanced DR scores compared to sustained low group. Those with sustained high HbA1c had the most impact. High initial HbA1c had a greater impact on females, age <65, patients lacking exercise or diet control. Patients with low or moderate MR showed significantly higher HbA1c level at ophthalmologic visit, and increased risk developing STDR. Age ≥65 years was a protective factor against higher DR scores.
Conclusions: This study highlights the relationship between initial blood glucose levels at diabetes diagnosis, and subsequent HbA1c change during ophthalmology visits concerning DR severity and progression. High initial HbA1c might indicate the need for frequent ophthalmic visit.
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陳達慶 Ta-Ching ChenTaiwan
Speaker
Hidden Variants in Inherited Retinal Degeneration and Their Impact on Gene-Targeted TreatmentIn this short talk, we would like to share the experience about systematically identifying pathogenic splicing variants and characterizing their transcript-level consequences to enhance the the molecular diagnosis of inherited retinal degeneration (IRD). In 738 IRD families, a splicing variant detection pipeline, integrating two computational algorithms (SpliceAI and dbscSNV_ADA) with functional validation via minigene assays, was implemented to detect splice-disrupting variants beyond canonical sites. Splicing variants accounted for 14% of genetically diagnosed families. Of these, 4% were newly identified through our combined computational and experimental platform. Notably, 28% of all splice-disrupting variants, located in noncanonical, exonic, or deep-intronic regions, would likely have been missed by conventional analysis pipelines, which typically prioritize protein-coding changes and canonical splice sites, and often lack systematic evaluation of splicing effects beyond these regions. Five recurrent splice-disrupting variants were observed across multiple families, including EYS:c.5644+5G>A, which caused exon truncation and was found in 11 unrelated families. Functional assays confirmed aberrant splicing, and the associated phenotypes were consistent with known disease presentations. This study demonstrates the utility of a combined splicing variant detection platform in uncovering hidden pathogenic variants and improving IRD diagnostic yield. These findings have implications for refining genetic testing and guiding the development of splicing-targeted therapies.
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Taiji SakamotoJapan
Moderator
My journey of retinal detachmentIn the 1990s, I began studying retinal detachment (RD) as a model for neuronal degeneration, particularly apoptosis. I discovered that necrotic retinal cells release highly toxic substances, but the vitreous body neutralizes them. Taking advantage of this, we developed a vitreous surgery method using hyaluronic acid.
Subsequently, I worked as a surgeon to treat RD. At that time, vitreous surgery was extremely challenging because we could not visualize the retina or vitreous during surgery. Observing success in simplifying ILM peeling with ICG staining, I developed a method to visualize the vitreous using triamcinolone. Lacking knowledge about patents (At that time, we were already using this method), I initially let another doctor publish the first report, but later we conducted a prospective comparative study demonstrating that triamcinolone-assisted vitrectomy made the surgery safer. Our group then developed a safer vital dye called brilliant blue, which is now used worldwide.
While surgical techniques improved, the subjective nature of surgery made objective assessment difficult. To address this issue, I believed a national retinal RD was necessary and established the Japan RD Registry to collect data. Our findings revealed the reality of RD treatment in Japan, including a significant result that in more conservative regions, women were less likely to undergo surgery. This highlighted the need for societal intervention to ensure all patients receive care. Despite my efforts to avoid social activities by focusing on basic medicine and RD treatment, I concluded that improving society was essential to effectively treat RD.
許淑娟 Shwu-Jiuan SheuTaiwan
Moderator
Risk factors associated with sight threatening diabetic retinopathy (STDR) severity and progression in diabetes mellitus (DM) patientsPurpose: This study aims to examine factors associated with sight threatening diabetic retinopathy (STDR) severity and progression in diabetes mellitus (DM) patients. Specifically, we focus on the initial HbA1C at diagnosis, its change at ophthalmologic visit and medication adherence (MR).
Research Design and Methods: A prospective study involving 300 type II DM patients (≥20 years) was conducted from July 2022 to January 2024. MR was assessed using the Taiwanese version of the Morisky Medication Adherence Scale-8 (MMAS-8). DR progression was evaluated through a defined clinical scoring system. Statistical analyses included chi-square tests and logistic regression to examine the factors associated with STDR severity and progression.
Results: After excluding 122 patients for missing data, 178 participants were analyzed. Changes in HbA1c were strongly associated with STDR. Both improvements and deteriorations or sustained high in HbA1c levels were linked to an increased likelihood of advanced DR scores compared to sustained low group. Those with sustained high HbA1c had the most impact. High initial HbA1c had a greater impact on females, age <65, patients lacking exercise or diet control. Patients with low or moderate MR showed significantly higher HbA1c level at ophthalmologic visit, and increased risk developing STDR. Age ≥65 years was a protective factor against higher DR scores.
Conclusions: This study highlights the relationship between initial blood glucose levels at diabetes diagnosis, and subsequent HbA1c change during ophthalmology visits concerning DR severity and progression. High initial HbA1c might indicate the need for frequent ophthalmic visit.
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Fang LuChina
Speaker
Sub-retinal AAV-RS1 gene therapy for X linkage retinoschisis: one year follow upDepartment of Ophthalmology, West China Hospital, Sichuan University, Chengdu, Sichuan, China
State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, Sichuan University and Collaborative Innovation Center, Chengdu, Sichuan, China
X-linked retinoschisis (XLRS) is a rare congenital disease of the retina caused by mutations in the RS1 gene, which encodes retinoschisin, a protein involved in intercellular adhesion and likely retinal cellular organization. With a prevalence of about 1 in 15,000 to 30,000, XLRS is one of the main causes of juvenile macular degeneration in males. Previous gene therapy showed significant structure and function promotion in animal research, however, failed to achieve significant efficacy in clinical trials in XLRS patients with intra-vitreal delivery. Here we report the efficacy and safety of a small sample trial with sub-retinal delivery of AAV carrying human RS1 gene in 12 pediatric XLRS patients.
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盧海 Hai LuChina
Speaker
Pediatric Retinal Detachment following Penetrating KeratoplastyPediatric penetrating keratoplasty can usually be multiple procedures. Repeated invasive intraocular operations may cause long-term intraocular changes in both the anterior and posterior segments including retinal detachment. The management of pediatric retinal detachment following penetrating keratoplasty can be more challenging duo to small and hazy cornea conditions. Vitrectomy is usually the choice of surgery and the postop prognosis of both retina and graft remain unfavorable.
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梁建宏 Jian Hong LiangChina
Speaker
Surgical Treatment of Uveal TumorsMalignant and benign tumors of the uvea (iris, ciliary body, and choroid) are often challenging in clinical treatment. The surgical removal of tumors is based on vitreoretinal surgery techniques and is one of the very effective methods for treating uveal tumors. However, the surgery is quite complex and different surgical approaches need to be selected mainly depending on the size, location and malignancy of the tumor.
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Taiji SakamotoJapan
Speaker
My journey of retinal detachmentIn the 1990s, I began studying retinal detachment (RD) as a model for neuronal degeneration, particularly apoptosis. I discovered that necrotic retinal cells release highly toxic substances, but the vitreous body neutralizes them. Taking advantage of this, we developed a vitreous surgery method using hyaluronic acid.
Subsequently, I worked as a surgeon to treat RD. At that time, vitreous surgery was extremely challenging because we could not visualize the retina or vitreous during surgery. Observing success in simplifying ILM peeling with ICG staining, I developed a method to visualize the vitreous using triamcinolone. Lacking knowledge about patents (At that time, we were already using this method), I initially let another doctor publish the first report, but later we conducted a prospective comparative study demonstrating that triamcinolone-assisted vitrectomy made the surgery safer. Our group then developed a safer vital dye called brilliant blue, which is now used worldwide.
While surgical techniques improved, the subjective nature of surgery made objective assessment difficult. To address this issue, I believed a national retinal RD was necessary and established the Japan RD Registry to collect data. Our findings revealed the reality of RD treatment in Japan, including a significant result that in more conservative regions, women were less likely to undergo surgery. This highlighted the need for societal intervention to ensure all patients receive care. Despite my efforts to avoid social activities by focusing on basic medicine and RD treatment, I concluded that improving society was essential to effectively treat RD.
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Sarah CouplandUnited Kingdom
Speaker
Uveal melanoma prognostication: beyond chromosome 3Prognosis for uveal melanoma (UM) is determined by a combination of clinical, histopathological, and molecular factors. Clinical markers include tumour size and location, while histopathological factors include cell type and mitotic activity. The Liverpool Ocular Oncology Centre has a long track record in UM prognostication, and has devised an algorithm (LUMPO3) for more precise risk stratification and identifying patients at high risk for metastasis. It is a multiparametric model, which also included genetic data, particularly chromosome 3 and 8. It has been demonstrated that BAP1 immunohistochemistry is a very close surrogate for the status of the BAP1 gene, which if mutated is associated with a poor prognosis in UM. Our recent work has investigated the inclusion of BAP1 immunohistochemistry in LUMPO3, in labs where chromosomal analysis is not available. Early detection of metastatic UM is critical, as the prognosis is poor once widespread metastases develop. If detected earlier, surgical and newer immunotherapy options have been demonstrated to prolong survival.Decoding intraocular masqueradeIntraocular lymphomas can be divided into 3 main subtypes: primary vitreoretinal lymphoma (VRL), primary choroidal lymphoma, and secondary intraocular lymphoma. VRL is a rare but aggressive form of non-Hodgkin lymphoma that affects the eye. The most common subtype is a Diffuse large cell B-cell lymphoma (DLBCL), and displays a similar morphology, immuno- and genetic profile to the primary CNS lymphomas. Indeed, VRL can relapse in the CNS, and similarly CNSL can involve the eye. VRL often "masquerades" as chronic uveitis, making early and accurate diagnosis challenging but crucial for effective treatment and improved prognosis. In contrast, primary choroidal lymphoma is an indolent non-Hodgkin lymphoma similar to the Marginal Zone B-cell lymphomas of the ocular adnexa, and do not spread to the CNS. This lecture will provide an update about the biology, diagnostics and treatment of VRL and choroidal lymphomas. It will also provide examples of differential diagnoses to consider in vitrectomy specimens.Update of Ocular Adnexal LymphomasOcular adnexal lymphomas are most commonly non-Hodgkin lymphomas (NHL) that develop in the conjunctiva, eyelid, lacrimal gland, and orbit. The most common subtype is an extranodal marginal zone lymphoma (EMZL), which often presents as a painless, salmon-coloured lesion on the conjunctiva or as a mass causing symptoms like proptosis, double vision, or swelling in the orbit. Other common NHL of the ocular adnexa include follicular lymphomas, diffuse large cell B-cell lymphomas and mantle cell lymphomas. Treatment varies as per lymphoma subtype and requires joined-up assessment with the haematologists and radiologists. Typically treatment is local with low-dose radiation therapy being a standard option for localised disease, while systemic treatment may be used for more advanced cases. This lecture will provide an update about the biology, diagnostics and treatment of ocular adnexal lymphomas.
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701B
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12:10
13:10
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眼力健｜Johnson & Johnson
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Gerd U. AuffarthGermany
Speaker
Unhappy Patient with Two Different Diffractive IOLs.Title: Unhappy Patient with Two Different Diffractive IOLs
Author: Gerd U. Auffarth
This is a case report about a 76-year-old patient who attended my clinic in 2008. He underwent cataract surgery on his right eye and an IQ Restor SN6AD1 was implanted. The second eye was not operated on for almost nine years, and then, in 2017, the patient underwent cataract surgery on the left eye. Interestingly, a different surgeon performed the surgery and said that the original intraocular lens (IOL) was no longer available, so a Tecnis Symfony ZXR00 was implanted instead.
The patient was not satisfied with the outcome. He complained of blurred vision, could not read road signs while driving, and had different colour perception in both eyes.
He noticed that the image in his right eye with the blue filter lens appeared more brown than the image in his left eye, and he could not get used to this over the years. In daily life, this was very bothersome for him.
The patient complained that the doctors tried several corrective lenses and PCO laser was performed on the right eye. All without any positive effect on this vision.
The results of the visual acuity examination were: uncorrected 20/30 in both eyes and 20/25 binocularly for distance. For near vision, it was 20/40 in both eyes and 20/30 binocularly. His refraction was +0.5, -0.25 @ 130° in the right eye and +0.25, -0.5 @ 77° in the left eye.
The patient was not satisfied with the visual outcome and the different optics, as the AcrySof IQ Restor is a multifocal IOL with a 3.0 near addition and a blue light filter, whereas the Tecnis Symfony has an extended depth of focus design and no blue light filter.
The surgical options were IOL explantation of one or both lenses and reimplantation of either a monofocal or another multifocal intraocular lens. However, the previous laser capsulotomy on the right eye could be problematic for this. In addition, the patient did not want any extensive surgery.
The aim was to help him by achieving good binocular visual performance, with particular focus on visual quality and balanced performance. Visual acuity was not really something that could be addressed.
In the end, the patient received a special pinhole add-on lens (Morcher Extrafocus). This is a pinhole optic with a central opening of 1.3 mm, which was placed in the right eye. This reduced the amount of light entering the eye and consequently diminished colour perception, which made the visual impression more similar to that of the left eye. One week after the surgery, the patient was extremely satisfied, especially because he could see and read in balance. Visual acuity remained at 20/30, similar to before. However, after two months, his visual acuity had improved on both sides between 20/25 and 20/20, and it was 20/20 for distance and near vision as well.
He is now a very satisfied patient as he wouldn't say there is a big difference between his right and left eyes, he doesn't need glasses anymore, and his quality of life has improved.
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701B
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博士倫｜Bausch & Lomb
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林浤裕 Hung-Yu LinTaiwan
Moderator
Innovative Refractive Surgery with SILK: Achieving Precise Outcomes and Exploring Its Potential to Delay Presbyopia本演講聚焦 SILK應用於約40歲患者，探討屈光手術合併老花矯正時的術前精準規劃與留度決策。臨床經驗顯示，直接套用 LASIK 之留度策略於 SILK， 易導致雙眼不等視、遠距視力下降及融像不適；將預留度數減少50%後可獲得較佳的全程視力表現，同時減少雙眼不等視引發的不適。
SILK 採低能量 40 nJ/pulse、小光斑 1μm 並以雙凸透鏡（biconvex lenticule）設計，使微透鏡成形更精細、取出更容易，降低器械進出次數，進而提高屈光結果之可預測性與視覺品質。本演講將彙整台灣臨床病例與國際研究重點，解析景深延長之可能原因，並提出以精準化能量參數之建議，提升SILK術後度數之可預測性與提升患者滿意度。
701C
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卡爾蔡司｜CARL ZEISS
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林慧茹 Hui-Ju LinTaiwan
Moderator
Advances in Artificial Intelligence Models and Algorithms in Amblyopia and Strabismus Review of Artificial Intelligence (AI) models that detect strabismus and amblyopia risk factors from smartphone photos, videos, and images, facilitating large-scale, accessible community screening. Discussion on how AI is personalizing amblyopia therapy, thereby maximizing efficacy and engagement. Critical appraisal of the requirements for clinical validation, regulatory approval, and the ethical integration of these AI tools into standard ophthalmic practice.
AI is poised to fundamentally reshape the management of strabismus and amblyopia by introducing unprecedented levels of objectivity, accessibility, and personalization. the knowledge to understand, evaluate, and eventually integrate these powerful technologies into their practice to improve patient outcomes. AI screening and diagnosis to treatment optimization and monitoring.
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701E
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科林｜Clinico Inc.
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Prin RojanapongpunThailand
Speaker
Intraoperative Aberrometry: Benefits or Distractions?Intraoperative Aberrometry (IA) is a microscope-mounted aberrometer that uses a laser wavefront analyzer to provide an intraoperative refractometer with live measurement. IA utilizes real-time wavefront analysis to measure IOL power in the aphakic state (after I&A but before IOL implantation), guiding Toric IOL axis alignment, and confirming final refraction in the pseudophakic stage (after IOL implantation). IA serves as an IOL power verification process by providing aphakic measurements.
IA has demonstrated improved accuracy compared to preoperative biometry and is most beneficial in complex cases, including post-refractive surgery eyes, eyes with uncertainty in preoperative biometry, and cases involving premium and toric IOL implantation, which results in less postoperative residual astigmatism.
IA accuracy is highly dependent on meeting specific intraoperative conditions. Erroneous measurements can occur due to factors like eyelid squeezing, speculum pressure, eye position/fixation, abnormal eye pressure, media conditions (OVD type and refractive index), corneal status, small pupil size, and IOL specifics. Caution is recommended when IA readings disagree significantly with preoperative measurements (e.g., a vector difference of 0.5 D in cases of low astigmatism).
Conclusion: Intraoperative Aberrometry is beneficial, especially for eyes with abnormal axial length, prior refractive surgery, toric IOLs, multifocal lenses, or uncertain biometry. IA functions as an additional measurement and verification tool. While IA can be beneficial when the surgeon masters the technique and all variables are optimized, it could be a distraction if optimization is not met.
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盧兆功 Chao-Kung LuTaiwan
Speaker
Divide and Conquer: Establishing a Stable Foundation for BeginnersThe divide and conquer technique is the fundamental method that every cataract surgeon begins their training with. The divide and conquer phacoemulsification technique involves several steps. First, a proper capsulorhexis and excellent hydrodissection are performed to ensure the nucleus can be rotated freely. Next, the surgeon creates a deep groove and then cracks the nucleus into four quadrants. Finally, the nucleus is emulsified and aspirated piece by piece. Pearls for this method include deeply debulking the nucleus before cracking, ensuring all pieces are broken up before removal to facilitate easier rotation and extraction, and having strategies for managing both soft and hard cataracts.
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701G
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鈦沅｜UMI
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Justin SherwinAustralia
Speaker
Two Eyes, One Day: The Evolving Landscape of Immediate Sequential Cataract SurgeryImmediate bilateral sequential lens-based surgery is increasingly adopted as a safe, effective, and patient-centred option for cataract and lens-based refractive procedures. This presentation reviews recent evidence on epidemiology, practice patterns, and outcomes across cataract surgery, refractive lens exchange, and phakic IOL implantation.
Studies demonstrate high efficacy in achieving refractive targets, rapid recovery of binocular vision, and consistent improvements in quality of life. Advances in biometry, surgical technology, and IOL design have further enhanced predictability and safety. Safety remains central, with very low rates of bilateral complications when established risk-reduction protocols—separate instrumentation, asepsis, and adherence to guidelines—are followed.
Comparisons with delayed sequential surgery show equivalent visual and refractive outcomes, along with reduced healthcare burden. This session will highlight current evidence on efficacy, safety, visual and refractive outcomes, and patient-reported benefits, while considering future directions in the expanding role of immediate bilateral sequential lens-based surgery.
702
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13:20
13:35
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第20屆第三次會員大會｜Third time of 20th Member Assembly
701C
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潘志勤 Chih-Chin PanTaiwan
Moderator
眼科醫師在校園視力保健及公共衛生推廣中的角色摘要
眼科醫師在校園視力保健及公共衛生推廣中，扮演著遠超過「診療者」的多元且關鍵角色。他們是整個視力保健體系中的專家、倡議者、教育者與把關者。
眼科醫師在此領域中的多重角色：
一、 校園視力保健中的直接角色
在校園這個第一線場域，眼科醫師的角色從被動治療轉為主動出擊。
二、 公共衛生推廣中的核心角色
在更宏觀的公衛層面，眼科醫師是政策與民眾之間的橋樑，是推動全民視覺健康的引擎。
總結
眼科醫師在校園視力保健與公衛推廣中的角色，已從傳統的「醫療端」向前延伸至「預防端」和「政策端」。對於提升整體國民的視覺健康與生活品質，及一個國家的公共衛生和發展至關重要。
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賴俊杰 Chun-Chieh LaiTaiwan
Speaker
Trends and Market Share of Presbyopia-Correcting Intraocular Lenses in Taiwan & Asia In this section, we will talk about the trends and market share of presbyopia-correcting intraocular lenses in Taiwan and Asia.Minimize Further Dehiscence of Zonules in Patients with Large Zonular Weakness Zonular weakness increases the likelihood of dealing with complicated cataract surgery and encountering postoperative complications. These risks include intra- and postoperative complications from cataract surgery, such as posterior capsular rupture, vitreous loss, and lens dislocation and decentration.
Common risk factors for weak zonules are pseudoexfoliation syndrome, mature cataracts, high myopia, Marfan syndrome, and prior ocular surgery. Signs of weak zonules include iridodonesis, phacodonesis, abnormal anterior chamber depth or asymmetry, angle asymmetry on gonioscopy, and vitreous in the anterior chamber. Zonular dehiscence and lens subluxation or dislocation can be seen in advanced zonulopathy. But most of the time, weak zonules may not be noticed until after the surgery has begun. Intraoperative signs of weak zonules include anterior chamber depth fluctuation, difficulty puncturing the anterior lens capsule, star-shaped striae on the capsule surface during the capsulorhexis, lens movement when manipulations, and difficulty in rotating the nucleus within the capsular bag despite adequate hydrodissection.
In this video discussion, we will talk about how to minimize further dehiscence of zonules in patients with large zonular weakness during operation and make the cataract surgery safer.
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許粹剛 Tsui-Kang HsuTaiwan
Speaker
When the Capsule Gives Way: Winning the Posterior Rupture BattleCataract surgery is the most commonly performed operation in ophthalmology and despite tremendous instrumental and technological advancements, posterior capsular rupture (PCR) still occurs. PCR occurs both in all eye surgeons, although with a higher frequency in the newer starter group. Additionally, certain types of cataracts are prone to this development. If handled properly in a timely method, the eventual outcome may be no different from that of an uncomplicated case. However, improper management may lead to serious complications with a higher incidence of permanent visual impairment. The speech disclose the management of PCR from two perspectives: 1. Identifying patients with higher risk and know the sign of early PCR, and measures to manage such patients by surgical maneuver, and 2. Intraoperative management of posterior capsular rupture with anterior vitrectomy with different setting and various case scenarios to prevent further long-term complications. Solution for Residual Large Lens Material with PCRCompromise of the posterior capsule can occur in the hands of both new and experienced surgeons. Learning how to prevent, avoid, or efficiently manage posterior capsular rupture (PCR) is important. If PCR is present with residual lens material and vitreous loss, it is important to disentangle the vitreous from any nuclear/cortical fragments to ensure their safe removal without creating vitreous traction in case of retinal detachment. The vitreous can be stained by using preservative-free triamcinolone to delineate its presence in the anterior chamber and any incarceration in the wound. Anterior vitrectomy can be performed to remove the vitreous from the anterior segment properly. Alternatively, suppose the surgeon is comfortable with a pars plana approach which is better route. In that senario, a pars plana vitrectomy can be done, which helps to pull the vitreous back to the posterior segment, and avoids excessive anterior chamber manipulation. The pars plana approach may also permit better access to residual lens material—the vitrector may be used to clear nuclear and cortical material with a change in settings. At the end of the case, the wounds should be checked carefully to ensure no vitreous is present. A suture or more if necessary, depending on wound size, should be placed at the primary wound. Pupillary miosis should be done to inspect the pupil. If the pupil is peaked, there is likely vitreous still present in the anterior chamber and possibly in the wound. Once the vitreous is adequately cleared, one may carefully resume phacoemulsification and insert an IOL in various methods.
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黃宇軒 Yu-Hsuan HuangTaiwan
Speaker
Managing Large Posterior Capsular Rupture with Residual Cortex in Toric or Premium IOL CasesManaging a large posterior capsular rupture (PCR) during cataract surgery is particularly challenging when a one-piece toric or premium IOL is planned. This case demonstrates that, when partial posterior capsular support remains, in-the-bag implantation of a single-piece premium IOL is still feasible with careful assessment and technique.
A large central PCR occurred unexpectedly after nucleus removal. Early recognition, immediate stabilization of the anterior chamber with viscoelastic, lowering IOP, and preventing tear extension were essential steps. Residual cortex was safely removed using dry aspiration with a Simcoe cannula combined with gentle polishing, allowing complete cleanup without further damage.
Although alternative IOL options were unavailable, the rupture did not align with the astigmatic axis, and sufficient capsule remained to support a toric IOL. The IOL was placed in the bag, and reverse optic capture (ROC) was performed to enhance long-term stability. ROC preserved the effective lens position by capturing the optic anterior to the capsulorhexis while keeping the haptics in the bag.
Postoperatively, the IOL remained well-centered with favorable refractive outcomes. This case shows that large PCR does not necessarily preclude premium IOL use when managed with proper surgical strategy, including ROC.
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FAM Han BorSingapore
Speaker
Astigmatism with TK more Accurate for Toric Calculation?This presentation explores the impact of Total Keratometry (TK) on the calculation of toric intraocular lenses (IOLs), focusing on the role of posterior corneal astigmatism (PCA) in refractive outcomes. Drawing on large datasets and recent studies, it highlights that PCA is a significant factor in toric IOL planning, with traditional keratometry often leading to over-correction of with-the-rule (WTR) and under-correction of against-the-rule (ATR) astigmatism. The presentation reviews evidence showing that using measured PCA values, rather than predicted ones, improves the accuracy of postoperative astigmatism prediction, especially when the steep axis of PCA is non-vertical. Comparative analysis of various toric IOL formulas demonstrates that EVO formulas with measured PCA yield the smallest centroid errors and highest percentage of eyes within 0.50D of predicted astigmatism, particularly in cases with non-vertical PCA. The findings underscore the importance of incorporating TK and measured PCA into toric IOL calculations to optimise refractive outcomes for cataract patients.
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Gerd U. AuffarthGermany
Speaker
Unhappy Patient with Two Different Diffractive IOLs.Title: Unhappy Patient with Two Different Diffractive IOLs
Author: Gerd U. Auffarth
This is a case report about a 76-year-old patient who attended my clinic in 2008. He underwent cataract surgery on his right eye and an IQ Restor SN6AD1 was implanted. The second eye was not operated on for almost nine years, and then, in 2017, the patient underwent cataract surgery on the left eye. Interestingly, a different surgeon performed the surgery and said that the original intraocular lens (IOL) was no longer available, so a Tecnis Symfony ZXR00 was implanted instead.
The patient was not satisfied with the outcome. He complained of blurred vision, could not read road signs while driving, and had different colour perception in both eyes.
He noticed that the image in his right eye with the blue filter lens appeared more brown than the image in his left eye, and he could not get used to this over the years. In daily life, this was very bothersome for him.
The patient complained that the doctors tried several corrective lenses and PCO laser was performed on the right eye. All without any positive effect on this vision.
The results of the visual acuity examination were: uncorrected 20/30 in both eyes and 20/25 binocularly for distance. For near vision, it was 20/40 in both eyes and 20/30 binocularly. His refraction was +0.5, -0.25 @ 130° in the right eye and +0.25, -0.5 @ 77° in the left eye.
The patient was not satisfied with the visual outcome and the different optics, as the AcrySof IQ Restor is a multifocal IOL with a 3.0 near addition and a blue light filter, whereas the Tecnis Symfony has an extended depth of focus design and no blue light filter.
The surgical options were IOL explantation of one or both lenses and reimplantation of either a monofocal or another multifocal intraocular lens. However, the previous laser capsulotomy on the right eye could be problematic for this. In addition, the patient did not want any extensive surgery.
The aim was to help him by achieving good binocular visual performance, with particular focus on visual quality and balanced performance. Visual acuity was not really something that could be addressed.
In the end, the patient received a special pinhole add-on lens (Morcher Extrafocus). This is a pinhole optic with a central opening of 1.3 mm, which was placed in the right eye. This reduced the amount of light entering the eye and consequently diminished colour perception, which made the visual impression more similar to that of the left eye. One week after the surgery, the patient was extremely satisfied, especially because he could see and read in balance. Visual acuity remained at 20/30, similar to before. However, after two months, his visual acuity had improved on both sides between 20/25 and 20/20, and it was 20/20 for distance and near vision as well.
He is now a very satisfied patient as he wouldn't say there is a big difference between his right and left eyes, he doesn't need glasses anymore, and his quality of life has improved.
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陳矜芸 Chin-yun ChenTaiwan
Speaker
A Challenging Case: Lens Subluxation with Hypermature Cataract in Nystagmus Patient.A discussion about management of high risk cataract surgery. In nystagmus case, retrobulbar anesthesia before surgery is a good choice. In mature cataract surgery, we must face higher surgical risks to prevent more postoperative complications.If coupled with lens dislocation, what weapons can help us overcome the difficulty?In addition, carefulness and patience as well as calmness and calmness may be the biggest winners.
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曾垂鍊 Chui-Lien TsenTaiwan
Speaker
Operating on the Edge: Surviving Cataract Surgery in Post-AACG Zonular Disaster This video demonstrates the surgical management of a mature cataract in an eye with a history of acute angle-closure glaucoma (AACG) complicated by zonular dialysis. The procedure highlights key steps for anterior chamber stabilization, controlled capsulorhexis under shallow conditions, and safe nucleus removal using phaco techniques. Intraoperative support with capsular tension ring and viscoelastic-assisted chamber maintenance was critical to preserving capsular integrity.
Despite severe zonular weakness, careful pacing and early mechanical stabilization allowed successful in-the-bag intraocular lens implantation with minimal intraoperative complications. Postoperative recovery was stable with good visual outcome.
Cataract surgery after AACG with zonular compromise remains one of the most technically demanding situations in anterior segment surgery. This case illustrates that with meticulous fluidic control, supportive devices, and adaptive strategy, even a “zonular disaster” can end with a safe and satisfying surgical result.
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701B
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邱力毅 Li-Yi ChiuTaiwan
Speaker
Life as a U.S. Fellow: Challenges and Rewards in Housing, Transportation, and Family LifePursuing a medical fellowship in the United States offers invaluable clinical exposure, academic growth, and cultural experiences. Yet beyond the hospital walls, fellows often navigate a wide spectrum of practical and personal challenges that shape their daily lives. This session explores the realities of living abroad as an international fellow—from securing housing in an unfamiliar market to managing transportation needs such as car rental or purchase, as well as understanding school districts, childcare options, and family support systems.
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Lessons from My Journey in Medical Centers and Community Clinics
洪國烜 Kuo-Hsuan HungTaiwan
Moderator
Octopath traveler in Ophthalmology不論是仍在接受住院醫師訓練，或是剛取得專科醫師證書的眼科醫師，對於未來職涯及人生規劃的選擇，或多或少夾雜著期待、徬徨、與未知的情緒，並且存在疑問期望能獲得解答。透過今天的演講內容，將分享身為公費醫師，在完成眼科住院醫師訓練後，服務於各層級醫療院所的心路歷程。分享內容包括：眼科診所、離島醫院、地區及區域醫院，山地醫療的工作及服務經驗以及海外留學申請、博士班求學的經歷。希望透過個人經驗的分享，有助於年輕眼科醫師無痛做出生涯規劃並且激發不同的想法，找出最適合自己的道路。
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林韋寧 Wei-Ning LinTaiwan
Speaker
Challenge CaseA challenge case will be presented.離開與回歸：我在不同醫療場域中找到的眼科價值離開醫學中心到基層，三年後又再回到醫中就職，職涯中的轉折，是機運與選擇共同譜寫出的有趣故事。
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洪國烜 Kuo-Hsuan HungTaiwan
Speaker
Octopath traveler in Ophthalmology不論是仍在接受住院醫師訓練，或是剛取得專科醫師證書的眼科醫師，對於未來職涯及人生規劃的選擇，或多或少夾雜著期待、徬徨、與未知的情緒，並且存在疑問期望能獲得解答。透過今天的演講內容，將分享身為公費醫師，在完成眼科住院醫師訓練後，服務於各層級醫療院所的心路歷程。分享內容包括：眼科診所、離島醫院、地區及區域醫院，山地醫療的工作及服務經驗以及海外留學申請、博士班求學的經歷。希望透過個人經驗的分享，有助於年輕眼科醫師無痛做出生涯規劃並且激發不同的想法，找出最適合自己的道路。
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Back to Where It All Began: Growing Through My Journey from Hospital to Community and Back Again
李婉如 Wan-Ju LeeTaiwan
Speaker
回到起點，走得更遠：從醫中到基層，再回醫院的修煉之路 Back to Where It All Began: Growing Through My Journey from Hospital to Community and Back Again我從醫學中心出發，走進基層，最後又回到醫院。
一路上，遇見了很多病人，也遇見了更多「人生」。
在醫學中心，我上的是最高端的訓練、最精準的分工；到了基層，才發現病人會把人生功課一起帶來。
原本以為看診重點是診斷與治療，結果發現——有人要的是藥，有人要的是安心，有人只是想有人聽他說一下。
回到醫院後，我突然變比較會「看懂人心」，偶爾也更知道該什麼時候閉嘴、什麼時候開眼界。
這趟路教我：醫療不是換地方做同樣的事，而是換角度看同樣的人。
希望這次分享，能一起聊聊——醫路走走停停，其實也走得更遠。
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Survival Codes for Young Ophthalmologists Abroad: Visa × Housing × Essential Skills for Thriving Overseas
邱力毅 Li-Yi ChiuTaiwan
Moderator
Life as a U.S. Fellow: Challenges and Rewards in Housing, Transportation, and Family LifePursuing a medical fellowship in the United States offers invaluable clinical exposure, academic growth, and cultural experiences. Yet beyond the hospital walls, fellows often navigate a wide spectrum of practical and personal challenges that shape their daily lives. This session explores the realities of living abroad as an international fellow—from securing housing in an unfamiliar market to managing transportation needs such as car rental or purchase, as well as understanding school districts, childcare options, and family support systems.
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邱力毅 Li-Yi ChiuTaiwan
Speaker
Life as a U.S. Fellow: Challenges and Rewards in Housing, Transportation, and Family LifePursuing a medical fellowship in the United States offers invaluable clinical exposure, academic growth, and cultural experiences. Yet beyond the hospital walls, fellows often navigate a wide spectrum of practical and personal challenges that shape their daily lives. This session explores the realities of living abroad as an international fellow—from securing housing in an unfamiliar market to managing transportation needs such as car rental or purchase, as well as understanding school districts, childcare options, and family support systems.
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周昱百 Yu-Bai ChouTaiwan
Speaker
Journal of International Fellowship in Ocular OncologyOcular oncology is a uniquely challenging yet profoundly rewarding subspecialty, requiring clinical precision, multidisciplinary collaboration, and emotional resilience. As a young ophthalmologist stepping into an international fellowship, every day becomes a chapter — a blend of unfamiliar environments, demanding cases, and transformative mentorship. This talk shares a personal and professional narrative of training abroad in ocular oncology, highlighting the milestones, turning points, and practical lessons that shaped the journey.
Through exposure to a wide spectrum of ocular tumors — including retinoblastoma, choroidal melanoma, metastatic disease, vascular tumors, and rare pediatric entities — the fellowship experience broadens diagnostic insight and refines surgical decision-making. Hands-on participation in intra-arterial and intravitreal chemotherapy, plaque brachytherapy, and complex vitreoretinal oncology cases demonstrates how innovation continues to redefine patient care. Additionally, immersion in a high-volume international center fosters growth in research methodology, critical thinking, and global collaboration.
Beyond clinical skills, the fellowship cultivates cultural adaptability, communication across diverse teams, and a deeper understanding of patient-centered care. The presentation aims to offer young ophthalmologists a realistic yet inspiring perspective on pursuing international training — addressing expectations, challenges, opportunities, and the lasting impact on one’s career trajectory.
Ultimately, the “journal” of an international ocular oncology fellowship is more than a record of cases; it is a journey of becoming. This talk invites early-career ophthalmologists to explore the world beyond their home institutions and to discover how global exposure can shape the future of ocular oncology.
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邱力毅 Li-Yi ChiuTaiwan
Moderator
Life as a U.S. Fellow: Challenges and Rewards in Housing, Transportation, and Family LifePursuing a medical fellowship in the United States offers invaluable clinical exposure, academic growth, and cultural experiences. Yet beyond the hospital walls, fellows often navigate a wide spectrum of practical and personal challenges that shape their daily lives. This session explores the realities of living abroad as an international fellow—from securing housing in an unfamiliar market to managing transportation needs such as car rental or purchase, as well as understanding school districts, childcare options, and family support systems.
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Albert Y. WuCanada
Speaker
Success in Sight: Mastering Research, Residency, and Career Excellence in Ophthalmology"Early career ophthalmologists and trainees must balance clinical responsibilities with research productivity and career development. This session is designed for medical students, residents, fellows, and junior faculty who want to strengthen their foundation for long-term success in ophthalmology.
The presentation will offer practical guidance on enhancing research impact—how to identify meaningful projects, manage time effectively, and move ideas from concept to publication. Attendees will also learn strategies to avoid common pitfalls, leverage mentorship, and collaborate productively across disciplines. Beyond research, the talk will address career navigation, including how to recognize opportunities that align with individual strengths and values, and how to develop a clear trajectory in academic medicine, clinical practice, or industry.
By framing research and career planning as complementary, participants will gain tools to integrate both into their professional journey. The session will emphasize resilience, adaptability, and leadership, equipping attendees with the mindset and strategies needed to thrive in a rapidly evolving field.
Whether aiming to excel in residency, advance through fellowship, secure a faculty role, or engage in innovation, participants will leave with insights to chart a purposeful and fulfilling career path in ophthalmology."
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701E
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林慧茹 Hui-Ju LinTaiwan
Moderator
Advances in Artificial Intelligence Models and Algorithms in Amblyopia and Strabismus Review of Artificial Intelligence (AI) models that detect strabismus and amblyopia risk factors from smartphone photos, videos, and images, facilitating large-scale, accessible community screening. Discussion on how AI is personalizing amblyopia therapy, thereby maximizing efficacy and engagement. Critical appraisal of the requirements for clinical validation, regulatory approval, and the ethical integration of these AI tools into standard ophthalmic practice.
AI is poised to fundamentally reshape the management of strabismus and amblyopia by introducing unprecedented levels of objectivity, accessibility, and personalization. the knowledge to understand, evaluate, and eventually integrate these powerful technologies into their practice to improve patient outcomes. AI screening and diagnosis to treatment optimization and monitoring.
蔡紫薰 Tzu-Hsun TsaiTaiwan
Moderator
Facts and Myths: What We Need to Know About Atropine Eye DropsA study conducted in Taiwan during the 1990s demonstrated that atropine reduced myopia progression in a dose-dependent manner. Since that time, the clinical use of atropine in school-aged children has been widespread in Taiwan for more than two decades. Owing to this long history of high-concentration atropine prescriptions, Taiwan represents a distinctive setting in which to evaluate the long-term safety of atropine use. Using data from a large cohort within the NHIRD, we found that the incidence of ocular complications was higher among individuals with myopia compared with those without. However, among participants with myopia, the incidence of these complications did not differ between atropine users and nonusers, and higher cumulative doses of atropine were not associated with increased risk.
The long-term efficacy of atropine eye drops for myopia control also merits further investigation. The LAMP clinical trial demonstrated that continuous treatment with 0.05% atropine effectively controlled myopia progression over five years. In contrast, the ATLAS from Singapore reported that topical atropine use during childhood was not associated with long-term ocular complications; however, its long-term efficacy in myopia control was less conclusive. Furthermore, recent randomized clinical trials have yielded inconsistent findings regarding the effectiveness of low-dose atropine, and regulatory approval by the U.S. FDA remains pending. Further research is therefore warranted to refine atropine treatment strategies, including the optimal timing of initiation, adjustment of concentration, duration of therapy, and methods and timing of discontinuation. Most importantly, future work should aim to clarify the ultimate clinical significance and long-term benefits of atropine therapy for myopia control.
接軌國際：IMI 近視前期定義與台灣經驗分享Pre-myopia is an emerging concept in myopia prevention, referring to children within a specific age range who exhibit refractive errors that, along with certain risk factors, place them at increased risk of developing myopia and who may benefit from early intervention. This presentation focuses on the international definitions of pre-myopia and utilizes public health survey data and clinical evidence from Taiwan to analyze the prevalence of pre-myopia and explore issues related to myopia development.
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徐旭亮 Shiuh-Liang HsuTaiwan
Speaker
To compare the clinical trial result of 2 Euclid Ortho-K lens In this talk, 2 new designed Euclid Ortho-K lens, which had different DK value and target refraction, were compared. The correction efficacy, stablility and adverse effects were collected and compared in eyes of different refraction.
邱正仁 Cheng-Jen ChiuTaiwan
Speaker
Clinical Insights into High-Myopia Ortho-K: Lens Design Optimization, Cessation Effects, and Axial Length ShorteningOrthokeratology (Ortho-K) has become an important modality in myopia management, yet its performance in high myopia, its behavior after treatment cessation, and the phenomenon of axial length (AL) shortening remain key areas of clinical interest. This presentation summarizes current evidence and clinical experience using Euclid’s advanced designs, including Topaz dual reverse-curve lenses and demonstrate improved patient satisfaction compared with conventional designs. Clinical data indicate acceptable safety with modern high-Dk materials, though high myopes may exhibit increased risks of microcysts or central staining.
Discontinuation studies show a mild to moderate AL rebound predominantly within the first 6 months, with younger age (<14 years), shorter wear duration, and absence of bridging therapy as major risk factors. Bridging with 0.01–0.05% atropine or MiSight lenses reduces rebound magnitude. Early monitoring of AL, corneal biomechanics, and topography is essential for differentiating true elongation from pseudo-elongation.
Recent longitudinal datasets reveal that a subset of Ortho-K wearers—particularly older adolescents with moderate-to-high myopia—may exhibit sustained AL shortening beyond measurement variability. Studies suggest choroidal expansion, scleral remodeling, optical signaling (reduced lag and increased HOAs), and age-dependent ocular growth dynamics as contributing mechanisms.
Together, these findings refine clinical strategies for high-myopia Ortho-K fitting, guide safe cessation protocols, and highlight the possibility of AL shortening and may act as a potential biomarker for long-term treatment responsiveness.
MiSight for Myopia Control: Clinical Applications, Combination Therapy, and Discontinuation EffectsMiSight® is a dual-focus soft contact lens engineered to correct refractive error while simultaneously generating consistent peripheral myopic defocus through its alternating +2.00 D treatment zones and central correction zones. Designed for full-day wear—typically averaging 13 hours—the lens offers reliable optical signaling for myopia control while maintaining clear, spectacle-free vision.
Clinical experience demonstrates excellent compliance, rapid skill acquisition, and strong suitability for children who prefer daytime correction, have irregular sleep schedules, or experience intolerance to orthokeratology. Optimal fitting involves avoiding over-minus prescriptions to prevent unintended hyperopic defocus, closely monitoring visual acuity and axial length progression, and adjusting power only when combined criteria of decreased visual performance, autorefractor changes, and accelerated axial growth are met.
Evidence supports the efficacy of combining MiSight® with 0.05% atropine in children who exhibit insufficient response to pharmacologic monotherapy, particularly among low-to-moderate myopes. In contrast, 0.01% atropine co-administered with multifocal soft lenses does not demonstrate a clear additive effect.
Long-term follow-up studies reveal that treatment benefits are retained after discontinuation, with axial length and refractive development returning to age-appropriate physiological rates without rebound. Additional optical analyses confirm that the dual-focus design continues to deliver effective myopic defocus even in children transitioning from orthokeratology, likely due to improved compliance and neural adaptation.
Overall, MiSight® represents a safe, effective, and practical modality for pediatric myopia management, offering predictable therapeutic outcomes and stable behavior during cessation or treatment transitions
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莊怡群 Ann Yi-Chiun ChuangTaiwan
Speaker
Small-Optical-Zone Ortho-K in Myopia Control 小光心角膜塑型片於近視控制中的應用Orthokeratology (Ortho-K) represents the foundation of modern optical myopia control through the induction of peripheral myopic defocus. Subsequent optical interventions, including myopia-control spectacle and soft contact lenses, were developed based on the same principle. A newer advancement in this field is the small-optical-zone overnight Ortho-K design, exemplified by the myOK-pro lens. This approach preserves the advantages of conventional Ortho-K while enhancing myopia-control efficacy by reducing the central treatment zone to generate greater peripheral myopic defocus.
Traditional Ortho-K tends to provide stronger control in higher prescriptions, whereas low-myopia patients often experience limited defocus and consequently weaker outcomes. For children who are unsuitable for or unwilling to wear spectacles or soft lenses, this presents a therapeutic gap. Small-optical-zone designs aim to address this need by improving defocus magnitude for low-myopia patients. However, simply reducing the optical zone in older designs may increase visual disturbances such as flare and halo. Modern small-optical-zone lenses seek to overcome these limitations, offering optimized visual quality alongside improved myopia-control performance.
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徐旭亮 Shiuh-Liang HsuTaiwan
Speaker
To compare the clinical trial result of 2 Euclid Ortho-K lens In this talk, 2 new designed Euclid Ortho-K lens, which had different DK value and target refraction, were compared. The correction efficacy, stablility and adverse effects were collected and compared in eyes of different refraction.
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蔡德中 Der-Chong TsaiTaiwan
Speaker
豪雅光學近視控制鏡片 (Hoya MiYOSMART)為減緩兒童近視度數的進展，除了藥物、環境與行為策略，近年來還有多種光學介入方式可供選擇。 而這些光學措施主要是基於「周邊近視性離焦能抑制眼軸伸長」的實驗證據。
其中，DIMS（Defocus Incorporated Multiple Segments）鏡片為目前在臨床上研究最多的框架眼鏡技術。其核心設計為在鏡片中心光學區(直徑為9mm)的周邊，配置 396 個具有正3.5D的鏡片小區塊，形成持續性的近視性離焦刺激，以抑制眼軸增長。多項臨床研究顯示，相較於傳統單焦點眼鏡，DIMS 鏡片在減緩近視進展、控制眼軸伸長以及兒童配戴的耐受性方面均具有顯著優勢。本演講 將討論DIMS對於學齡前近視預防的可行性，並聚焦在對於DIMS反應不理想的個案處理。
卡爾蔡司成長睿鏡片 (Zeiss MyoCare)本演講為卡爾蔡司成長睿鏡片的第二部分，主要報告MyoCare與MyoCare S於歐洲與亞洲兒童族群 多中心、隨機對照臨床試驗結果，
歐洲 CEME 研究納入 234 名 6–13 歲兒童，配戴 MyoCare 一年後，相較單光眼鏡，近視度數進展減少 0.21 D、眼軸增長減少 0.14 mm，並顯著降低快速惡化者的比例（SE > −0.50D/yr：21.1% vs 39.3%）。中國 240 名兒童的雙盲隨機試驗顯示，在 12 個月與 24 個月的追蹤中，MyoCare 與 MyoCare S 均較單光眼鏡能顯著減緩眼軸延長及屈光度近視化的速度。12 個月時，MyoCare 與 MyoCare S 分別減少眼軸延長 41% 與 34%，並減緩近視進展 48% 與 45%。24 個月結果同樣顯示穩定的控制效果，眼軸延長分別減少 38% 與 28%。此外，以「Emmetropic Progression Ratio」分析，兩款鏡片皆能使眼軸生長趨近正視化發展，MyoCare 與 MyoCare S 的比率分別達 70% 與 68%。兩種設計在整體控制效果上相近，亦展現高度安全性與良好配戴順應性。綜合而言，MyoCare 與 MyoCare S鏡片具備良好視力品質，不論在亞洲或歐洲族群皆能有效減緩眼軸生長，使眼球發育更接近正視化軌跡，是目前具跨族群證據支持的近視控制鏡片解決方案。
眼科醫師在校園視力保健及公衛推廣中的角色面對近視狂潮，眼科醫師在校園視力保健與公衛推廣中扮演關鍵角色: Partner, Educator, Advisor。近視防治有兩大策略：延後近視發生（近視預防） 與 減緩進展（近視控制），其中近視控制主要在診間進行，而近視預防則必須走入校園。以宜蘭縣模式為例，由眼科醫師到園所進行散瞳驗光檢查，可達 92% 的大班幼兒篩檢率，顯示其優於學童自行就醫。散瞳驗光能找出視力正常的低度近視與近視前期，凸顯眼科專業在校園篩檢中的必要性。 眼科醫師同時是 宣傳視力保健知識的教育者，除了在校園演講推動「天天戶外 120 分鐘」、近視控制新知等實證策略、支持教師與校護成為對抗近視前線的重要夥伴。我們亦可針對近視前期兒童的家長，透過社群平台以圖像化、影音化內容，精準推廣正確近視衛教，促進高近視風險學童與家長的警覺心與配合度。此外，眼科醫師也能是 政策建言者。過去十多年來，眼科醫師持續協助衛政與教育單位制定重要政策，包括 2009 年全國天天戶外120政策、2013 年北市國小近視篩檢、2014 年宜蘭縣幼兒園到校散瞳驗光、2022 年宜蘭縣近視前期大班轉介方案，以及 2023 年宜蘭縣國小視力紀錄卡向下延伸至幼兒園。本演講將分享眼科醫師在校園視力保健與公衛推廣參與者、教育者與建言者 的三重的角色。
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劉春甫 Chun-Fu LiuTaiwan
Speaker
依視路星趣控鏡片 (Essilor Stellest)We will discuss the clinical experience of using this lens, the Essilor Stellest lens.
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劉春甫 Chun-Fu LiuTaiwan
Speaker
依視路星趣控鏡片 (Essilor Stellest)We will discuss the clinical experience of using this lens, the Essilor Stellest lens.
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莊怡群 Ann Yi-Chiun ChuangTaiwan
Speaker
Small-Optical-Zone Ortho-K in Myopia Control 小光心角膜塑型片於近視控制中的應用Orthokeratology (Ortho-K) represents the foundation of modern optical myopia control through the induction of peripheral myopic defocus. Subsequent optical interventions, including myopia-control spectacle and soft contact lenses, were developed based on the same principle. A newer advancement in this field is the small-optical-zone overnight Ortho-K design, exemplified by the myOK-pro lens. This approach preserves the advantages of conventional Ortho-K while enhancing myopia-control efficacy by reducing the central treatment zone to generate greater peripheral myopic defocus.
Traditional Ortho-K tends to provide stronger control in higher prescriptions, whereas low-myopia patients often experience limited defocus and consequently weaker outcomes. For children who are unsuitable for or unwilling to wear spectacles or soft lenses, this presents a therapeutic gap. Small-optical-zone designs aim to address this need by improving defocus magnitude for low-myopia patients. However, simply reducing the optical zone in older designs may increase visual disturbances such as flare and halo. Modern small-optical-zone lenses seek to overcome these limitations, offering optimized visual quality alongside improved myopia-control performance.
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蔡德中 Der-Chong TsaiTaiwan
Speaker
豪雅光學近視控制鏡片 (Hoya MiYOSMART)為減緩兒童近視度數的進展，除了藥物、環境與行為策略，近年來還有多種光學介入方式可供選擇。 而這些光學措施主要是基於「周邊近視性離焦能抑制眼軸伸長」的實驗證據。
其中，DIMS（Defocus Incorporated Multiple Segments）鏡片為目前在臨床上研究最多的框架眼鏡技術。其核心設計為在鏡片中心光學區(直徑為9mm)的周邊，配置 396 個具有正3.5D的鏡片小區塊，形成持續性的近視性離焦刺激，以抑制眼軸增長。多項臨床研究顯示，相較於傳統單焦點眼鏡，DIMS 鏡片在減緩近視進展、控制眼軸伸長以及兒童配戴的耐受性方面均具有顯著優勢。本演講 將討論DIMS對於學齡前近視預防的可行性，並聚焦在對於DIMS反應不理想的個案處理。
卡爾蔡司成長睿鏡片 (Zeiss MyoCare)本演講為卡爾蔡司成長睿鏡片的第二部分，主要報告MyoCare與MyoCare S於歐洲與亞洲兒童族群 多中心、隨機對照臨床試驗結果，
歐洲 CEME 研究納入 234 名 6–13 歲兒童，配戴 MyoCare 一年後，相較單光眼鏡，近視度數進展減少 0.21 D、眼軸增長減少 0.14 mm，並顯著降低快速惡化者的比例（SE > −0.50D/yr：21.1% vs 39.3%）。中國 240 名兒童的雙盲隨機試驗顯示，在 12 個月與 24 個月的追蹤中，MyoCare 與 MyoCare S 均較單光眼鏡能顯著減緩眼軸延長及屈光度近視化的速度。12 個月時，MyoCare 與 MyoCare S 分別減少眼軸延長 41% 與 34%，並減緩近視進展 48% 與 45%。24 個月結果同樣顯示穩定的控制效果，眼軸延長分別減少 38% 與 28%。此外，以「Emmetropic Progression Ratio」分析，兩款鏡片皆能使眼軸生長趨近正視化發展，MyoCare 與 MyoCare S 的比率分別達 70% 與 68%。兩種設計在整體控制效果上相近，亦展現高度安全性與良好配戴順應性。綜合而言，MyoCare 與 MyoCare S鏡片具備良好視力品質，不論在亞洲或歐洲族群皆能有效減緩眼軸生長，使眼球發育更接近正視化軌跡，是目前具跨族群證據支持的近視控制鏡片解決方案。
眼科醫師在校園視力保健及公衛推廣中的角色面對近視狂潮，眼科醫師在校園視力保健與公衛推廣中扮演關鍵角色: Partner, Educator, Advisor。近視防治有兩大策略：延後近視發生（近視預防） 與 減緩進展（近視控制），其中近視控制主要在診間進行，而近視預防則必須走入校園。以宜蘭縣模式為例，由眼科醫師到園所進行散瞳驗光檢查，可達 92% 的大班幼兒篩檢率，顯示其優於學童自行就醫。散瞳驗光能找出視力正常的低度近視與近視前期，凸顯眼科專業在校園篩檢中的必要性。 眼科醫師同時是 宣傳視力保健知識的教育者，除了在校園演講推動「天天戶外 120 分鐘」、近視控制新知等實證策略、支持教師與校護成為對抗近視前線的重要夥伴。我們亦可針對近視前期兒童的家長，透過社群平台以圖像化、影音化內容，精準推廣正確近視衛教，促進高近視風險學童與家長的警覺心與配合度。此外，眼科醫師也能是 政策建言者。過去十多年來，眼科醫師持續協助衛政與教育單位制定重要政策，包括 2009 年全國天天戶外120政策、2013 年北市國小近視篩檢、2014 年宜蘭縣幼兒園到校散瞳驗光、2022 年宜蘭縣近視前期大班轉介方案，以及 2023 年宜蘭縣國小視力紀錄卡向下延伸至幼兒園。本演講將分享眼科醫師在校園視力保健與公衛推廣參與者、教育者與建言者 的三重的角色。
蔡紫薰 Tzu-Hsun TsaiTaiwan
Speaker
Facts and Myths: What We Need to Know About Atropine Eye DropsA study conducted in Taiwan during the 1990s demonstrated that atropine reduced myopia progression in a dose-dependent manner. Since that time, the clinical use of atropine in school-aged children has been widespread in Taiwan for more than two decades. Owing to this long history of high-concentration atropine prescriptions, Taiwan represents a distinctive setting in which to evaluate the long-term safety of atropine use. Using data from a large cohort within the NHIRD, we found that the incidence of ocular complications was higher among individuals with myopia compared with those without. However, among participants with myopia, the incidence of these complications did not differ between atropine users and nonusers, and higher cumulative doses of atropine were not associated with increased risk.
The long-term efficacy of atropine eye drops for myopia control also merits further investigation. The LAMP clinical trial demonstrated that continuous treatment with 0.05% atropine effectively controlled myopia progression over five years. In contrast, the ATLAS from Singapore reported that topical atropine use during childhood was not associated with long-term ocular complications; however, its long-term efficacy in myopia control was less conclusive. Furthermore, recent randomized clinical trials have yielded inconsistent findings regarding the effectiveness of low-dose atropine, and regulatory approval by the U.S. FDA remains pending. Further research is therefore warranted to refine atropine treatment strategies, including the optimal timing of initiation, adjustment of concentration, duration of therapy, and methods and timing of discontinuation. Most importantly, future work should aim to clarify the ultimate clinical significance and long-term benefits of atropine therapy for myopia control.
接軌國際：IMI 近視前期定義與台灣經驗分享Pre-myopia is an emerging concept in myopia prevention, referring to children within a specific age range who exhibit refractive errors that, along with certain risk factors, place them at increased risk of developing myopia and who may benefit from early intervention. This presentation focuses on the international definitions of pre-myopia and utilizes public health survey data and clinical evidence from Taiwan to analyze the prevalence of pre-myopia and explore issues related to myopia development.
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林慧茹 Hui-Ju LinTaiwan
Speaker
Advances in Artificial Intelligence Models and Algorithms in Amblyopia and Strabismus Review of Artificial Intelligence (AI) models that detect strabismus and amblyopia risk factors from smartphone photos, videos, and images, facilitating large-scale, accessible community screening. Discussion on how AI is personalizing amblyopia therapy, thereby maximizing efficacy and engagement. Critical appraisal of the requirements for clinical validation, regulatory approval, and the ethical integration of these AI tools into standard ophthalmic practice.
AI is poised to fundamentally reshape the management of strabismus and amblyopia by introducing unprecedented levels of objectivity, accessibility, and personalization. the knowledge to understand, evaluate, and eventually integrate these powerful technologies into their practice to improve patient outcomes. AI screening and diagnosis to treatment optimization and monitoring.
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邱正仁 Cheng-Jen ChiuTaiwan
Speaker
Clinical Insights into High-Myopia Ortho-K: Lens Design Optimization, Cessation Effects, and Axial Length ShorteningOrthokeratology (Ortho-K) has become an important modality in myopia management, yet its performance in high myopia, its behavior after treatment cessation, and the phenomenon of axial length (AL) shortening remain key areas of clinical interest. This presentation summarizes current evidence and clinical experience using Euclid’s advanced designs, including Topaz dual reverse-curve lenses and demonstrate improved patient satisfaction compared with conventional designs. Clinical data indicate acceptable safety with modern high-Dk materials, though high myopes may exhibit increased risks of microcysts or central staining.
Discontinuation studies show a mild to moderate AL rebound predominantly within the first 6 months, with younger age (<14 years), shorter wear duration, and absence of bridging therapy as major risk factors. Bridging with 0.01–0.05% atropine or MiSight lenses reduces rebound magnitude. Early monitoring of AL, corneal biomechanics, and topography is essential for differentiating true elongation from pseudo-elongation.
Recent longitudinal datasets reveal that a subset of Ortho-K wearers—particularly older adolescents with moderate-to-high myopia—may exhibit sustained AL shortening beyond measurement variability. Studies suggest choroidal expansion, scleral remodeling, optical signaling (reduced lag and increased HOAs), and age-dependent ocular growth dynamics as contributing mechanisms.
Together, these findings refine clinical strategies for high-myopia Ortho-K fitting, guide safe cessation protocols, and highlight the possibility of AL shortening and may act as a potential biomarker for long-term treatment responsiveness.
MiSight for Myopia Control: Clinical Applications, Combination Therapy, and Discontinuation EffectsMiSight® is a dual-focus soft contact lens engineered to correct refractive error while simultaneously generating consistent peripheral myopic defocus through its alternating +2.00 D treatment zones and central correction zones. Designed for full-day wear—typically averaging 13 hours—the lens offers reliable optical signaling for myopia control while maintaining clear, spectacle-free vision.
Clinical experience demonstrates excellent compliance, rapid skill acquisition, and strong suitability for children who prefer daytime correction, have irregular sleep schedules, or experience intolerance to orthokeratology. Optimal fitting involves avoiding over-minus prescriptions to prevent unintended hyperopic defocus, closely monitoring visual acuity and axial length progression, and adjusting power only when combined criteria of decreased visual performance, autorefractor changes, and accelerated axial growth are met.
Evidence supports the efficacy of combining MiSight® with 0.05% atropine in children who exhibit insufficient response to pharmacologic monotherapy, particularly among low-to-moderate myopes. In contrast, 0.01% atropine co-administered with multifocal soft lenses does not demonstrate a clear additive effect.
Long-term follow-up studies reveal that treatment benefits are retained after discontinuation, with axial length and refractive development returning to age-appropriate physiological rates without rebound. Additional optical analyses confirm that the dual-focus design continues to deliver effective myopic defocus even in children transitioning from orthokeratology, likely due to improved compliance and neural adaptation.
Overall, MiSight® represents a safe, effective, and practical modality for pediatric myopia management, offering predictable therapeutic outcomes and stable behavior during cessation or treatment transitions
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蔡紫薰 Tzu-Hsun TsaiTaiwan
Speaker
Facts and Myths: What We Need to Know About Atropine Eye DropsA study conducted in Taiwan during the 1990s demonstrated that atropine reduced myopia progression in a dose-dependent manner. Since that time, the clinical use of atropine in school-aged children has been widespread in Taiwan for more than two decades. Owing to this long history of high-concentration atropine prescriptions, Taiwan represents a distinctive setting in which to evaluate the long-term safety of atropine use. Using data from a large cohort within the NHIRD, we found that the incidence of ocular complications was higher among individuals with myopia compared with those without. However, among participants with myopia, the incidence of these complications did not differ between atropine users and nonusers, and higher cumulative doses of atropine were not associated with increased risk.
The long-term efficacy of atropine eye drops for myopia control also merits further investigation. The LAMP clinical trial demonstrated that continuous treatment with 0.05% atropine effectively controlled myopia progression over five years. In contrast, the ATLAS from Singapore reported that topical atropine use during childhood was not associated with long-term ocular complications; however, its long-term efficacy in myopia control was less conclusive. Furthermore, recent randomized clinical trials have yielded inconsistent findings regarding the effectiveness of low-dose atropine, and regulatory approval by the U.S. FDA remains pending. Further research is therefore warranted to refine atropine treatment strategies, including the optimal timing of initiation, adjustment of concentration, duration of therapy, and methods and timing of discontinuation. Most importantly, future work should aim to clarify the ultimate clinical significance and long-term benefits of atropine therapy for myopia control.
接軌國際：IMI 近視前期定義與台灣經驗分享Pre-myopia is an emerging concept in myopia prevention, referring to children within a specific age range who exhibit refractive errors that, along with certain risk factors, place them at increased risk of developing myopia and who may benefit from early intervention. This presentation focuses on the international definitions of pre-myopia and utilizes public health survey data and clinical evidence from Taiwan to analyze the prevalence of pre-myopia and explore issues related to myopia development.
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701D
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白內障手術 Wet Lab 實作｜Wet Lab Practical Course-Cataract Surgery
703
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屈光手術 Wet Lab 實作｜Wet Lab Practical Course-Refractive Surgery
六福萬怡 Courtyard by Marriott Taipei
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