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08:20
12:00
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ZH
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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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