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08:30
12:00
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EN
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Thomas KOHNENGermany
Moderator
Power and Precision: The New Era of Phacoemulsification TechnologyModern phacoemulsification technology has evolved into a precise, efficient, and customizable system that supports both standard cataract surgery and refractive visual outcomes. Contemporary devices integrate intelligent fluidics, responsive energy delivery, and enhanced intraoperative control, aiming to improve safety and reduce corneal trauma. Femtosecond laser platforms contribute by standardising capsulotomies, fragmenting the nucleus, and enabling astigmatism-neutral corneal incisions, which supports predictable refractive results and facilitates the use of advanced IOL designs. Astigmatism management remains central to postoperative quality, with digital marking systems improving axis alignment and complementing toric IOL implantation. Sustainability is gaining relevance as reusable tubing, cassettes, and blades reduce environmental burden without compromising safety. Across these domains, innovation focuses on precision, patient-centred refractive planning, and resource-conscious implementation. The new era of phacoemulsification combines technological refinement, optical optimisation, and sustainable strategy to advance cataract surgery outcomes.Bridging Cornea and Lens: The Modern Role of Phakic IOLs in a Myopic WorldPhakic intraocular lenses provide a valuable refractive option for patients with myopia extending beyond the safe limits of corneal laser procedures. Positioned either in the anterior or posterior chamber, they preserve the natural crystalline lens and maintain corneal structure, making them particularly suitable when optical quality, contrast vision, or biomechanical stability must be prioritised. Current guidelines support their use from low to high myopic ranges, with toric designs enabling simultaneous astigmatism correction. Compared with laser-based approaches, phakic IOLs deliver strong visual performance and high patient satisfaction, especially in moderate and high myopia. Long-term outcomes highlight the need for monitoring endothelial cell behaviour and cataract formation as part of routine follow-up. When cataract develops later in life, bilensectomy combines IOL explantation with cataract surgery to preserve refractive goals. Phakic IOLs bridge the space between corneal and lenticular refractive strategies and remain central in modern myopia management.From Awareness to Action: Stepwise Learning to Manage Capsular Rupture During Cataract SurgeryPosterior capsular rupture remains a decisive intraoperative challenge during cataract surgery, most often occurring during lens removal, cortical aspiration, or IOL implantation. Successful management requires early recognition, maintenance of chamber stability, and prevention of nuclear descent into the vitreous. This work presents a structured escalation strategy guiding surgeons from awareness of risk factors to practical intervention. Key steps include controlled viscoelastic support, careful manipulation of remaining lens material, and appropriate anterior or pars plana vitrectomy when vitreous prolapse occurs. IOL selection must be adapted to capsular integrity, allowing placement in the bag when stable or in the sulcus with or without optic capture when support is limited; alternative fixation methods remain essential fallback options. Case examples illustrate that even multifocal IOL implantation is achievable despite rupture if capsular support is preserved and decision-making remains systematic. The stepwise approach aims to enhance intraoperative safety, reduce complication impact, and preserve refractive goals in modern cataract surgery.
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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.
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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盧兆功 醫師Taiwan
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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簡湘文 醫師Taiwan
Speaker
Stop and Chop: Bridging Classic Sculpting with Modern ChoppingStop and Chop remains a cornerstone phacoemulsification technique that elegantly bridges the precision of classic sculpting with the efficiency of modern chopping. This 10-minute lecture demonstrates a streamlined, low-energy approach to nucleus management, emphasizing initial central sculpting to create a secure mechanical barrier, followed by controlled cracking and targeted chopping to minimize ultrasound energy and endothelial stress. Key steps include optimized trench depth, chopper positioning for safe lens rotation, and sequential quadrant emulsification with fluidic balance.
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莊智鈞 醫師Taiwan
Speaker
Chopping Strategies: Horizontal, Vertical, Prechop, and BeyondThe "Phaco Chop" techniques—Horizontal, Vertical, and Prechop—are advanced surgical strategies used in phacoemulsification to fragment the eye's cloudy lens nucleus. The goal of all chop techniques is to reduce the amount of ultrasound energy and time needed for removal, which minimizes damage to the corneal endothelium and other ocular structures. Phaco Chop leads to significant surgical benefits including (1) Minimized Zonular Stress: By stabilizing the nucleus with the phaco tip and applying opposing forces centripetally, the stress transmitted to the delicate zonules is drastically reduced compared to the grooving required in the "Divide and Conquer" technique. (2) Reduced Phaco Power & Time: Replacing the need to sculpt trenches with mechanical cleavage saves ultrasound energy and shortens the overall procedure time. (3) Safety in Challenging Cases: Small Pupils: The technique keeps all major movements contained within the central 3–4 mm of the pupil, avoiding the need to work under a small iris. (4) Dense Cataracts: Vertical chop, in particular, can efficiently split hard, brunescent nuclei that would otherwise require excessive, damaging ultrasound energy. In short, Phaco Chop is an elegant solution in cataract surgery that leverages the physical properties of the lens (cleavage planes) to substitute energy-intensive destruction with controlled, mechanical fragmentation, resulting in a safer, faster, and less traumatic operation for the eye. Beyond the basic Horizontal and Vertical Phaco Chop techniques, various advanced and hybrid strategies have also evolved in cataract surgery to improve safety, efficiency, and adaptability for different cataract types and eye conditions.
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Moderator
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Thomas KOHNENGermany
Speaker
Power and Precision: The New Era of Phacoemulsification TechnologyModern phacoemulsification technology has evolved into a precise, efficient, and customizable system that supports both standard cataract surgery and refractive visual outcomes. Contemporary devices integrate intelligent fluidics, responsive energy delivery, and enhanced intraoperative control, aiming to improve safety and reduce corneal trauma. Femtosecond laser platforms contribute by standardising capsulotomies, fragmenting the nucleus, and enabling astigmatism-neutral corneal incisions, which supports predictable refractive results and facilitates the use of advanced IOL designs. Astigmatism management remains central to postoperative quality, with digital marking systems improving axis alignment and complementing toric IOL implantation. Sustainability is gaining relevance as reusable tubing, cassettes, and blades reduce environmental burden without compromising safety. Across these domains, innovation focuses on precision, patient-centred refractive planning, and resource-conscious implementation. The new era of phacoemulsification combines technological refinement, optical optimisation, and sustainable strategy to advance cataract surgery outcomes.Bridging Cornea and Lens: The Modern Role of Phakic IOLs in a Myopic WorldPhakic intraocular lenses provide a valuable refractive option for patients with myopia extending beyond the safe limits of corneal laser procedures. Positioned either in the anterior or posterior chamber, they preserve the natural crystalline lens and maintain corneal structure, making them particularly suitable when optical quality, contrast vision, or biomechanical stability must be prioritised. Current guidelines support their use from low to high myopic ranges, with toric designs enabling simultaneous astigmatism correction. Compared with laser-based approaches, phakic IOLs deliver strong visual performance and high patient satisfaction, especially in moderate and high myopia. Long-term outcomes highlight the need for monitoring endothelial cell behaviour and cataract formation as part of routine follow-up. When cataract develops later in life, bilensectomy combines IOL explantation with cataract surgery to preserve refractive goals. Phakic IOLs bridge the space between corneal and lenticular refractive strategies and remain central in modern myopia management.From Awareness to Action: Stepwise Learning to Manage Capsular Rupture During Cataract SurgeryPosterior capsular rupture remains a decisive intraoperative challenge during cataract surgery, most often occurring during lens removal, cortical aspiration, or IOL implantation. Successful management requires early recognition, maintenance of chamber stability, and prevention of nuclear descent into the vitreous. This work presents a structured escalation strategy guiding surgeons from awareness of risk factors to practical intervention. Key steps include controlled viscoelastic support, careful manipulation of remaining lens material, and appropriate anterior or pars plana vitrectomy when vitreous prolapse occurs. IOL selection must be adapted to capsular integrity, allowing placement in the bag when stable or in the sulcus with or without optic capture when support is limited; alternative fixation methods remain essential fallback options. Case examples illustrate that even multifocal IOL implantation is achievable despite rupture if capsular support is preserved and decision-making remains systematic. The stepwise approach aims to enhance intraoperative safety, reduce complication impact, and preserve refractive goals in modern cataract surgery.
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姚克 Yao KeChina
Speaker
Adances in FLACS Cataract surgery in China has experienced a profound transformation, evolving from traditional practices
to the implementation of advanced techniques like Femtosecond Laser-Assisted Cataract Surgery
(FLACS). This lecture provides an overview of the recent clinical research in Mainland China, focusing on
optimizing surgical workflows, refining patient selection criteria, and evaluating visual and refractive
outcomes associated with FLACS. Data from these studies have contributed to evidence-based protocols
that support the safe and effective implementation of laser-assisted cataract procedures across diverse
clinical settings.
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Panel Discussion
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.
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
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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Filomena RIBEIROPortugal
Moderator
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.
Burkhard DickGermany
Moderator
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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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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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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王元聖 醫師Taiwan
Speaker
Prevention and Management of Complications in Cataract Surgery: A Retinal Specialist’s PerspectiveCataract surgery is one of the most common and successful intraocular surgeries performed worldwide. However, sight-threatening complications that involve the posterior segment can occur. The complication rate after cataract surgery is relatively low, but it is important to recognize these complications early and treat them appropriately. In this presentattion, I will review the major posterior segment complications of cataract surgery, such as retained lens fragments, postoperative endophthalmitis, pseudophakic retinal detachment, and cystoid macular edema.
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Moderator
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Joaquín FERNÁNDEZSpain
Speaker
Simultaneous Vision IOLs ESCRS ClassificationThe rapid expansion of intraocular lens (IOL) designs and the increasing volume of clinical research supporting their functional outcomes have underscored the need for a unified and globally standardized Functional Vision Framework. The European, American, Asia-Pacific, and Latin American Societies of Cataract and Refractive Surgeons have collaboratively established the Global Functional Vision Working Group (FVWG) to harmonize terminology, methodologies, and outcome reporting in IOL evaluation. This initiative introduces a Functional Classification based on the depth of field (DOFi) and visual acuity enhancement across intermediate to near distances, organized into six progressive categories reflecting different visual performance profiles. Unlike regulatory classifications, such as ISO 11979-7:2024, which focus on safety and pre-market efficacy, the FVWG Functional Classification aims to provide post-market, clinically meaningful differentiation that aligns with patient-centered care and real-world functional benefits. The framework also advocates the integration of additional endpoints, including contrast sensitivity, biometric influences, and validated patient-reported outcome measures such as the AIOLIS questionnaire. Future directions emphasize the development of guidelines to assess the certainty of functional performance based on a hierarchy of evidence, from optical bench predictions to clinical validation and meta-analyses. By aligning technical and patient-oriented perspectives, the FVWG’s Functional Vision Framework represents a major advancement toward global standardization in IOL research and clinical practice. It provides clinicians, researchers, and industry with a robust foundation for consistent measurement, transparent communication, and improved shared decision-making in the selection and evaluation of IOL technologies.
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賴俊杰 醫師Taiwan
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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Moderator
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Pavel STODULKA
Speaker
ESCRS Refractive Surgery GuidelinesThe ESCRS refractive surgery guidelines are evidence-based and provide fundamental classifications of ametropia, target refraction, and available refractive surgical procedures. For each procedure, the guidelines outline its variants, indications, advantages, and limitations. They also define safety thresholds and technical limits applicable to refractive surgery.
The guidelines describe the key components of the refractive surgery patient journey: (1) screening and patient selection, (2) diagnostic and preoperative evaluation, (3) procedure selection, (4) perioperative management, and (5) postoperative follow-up. Patient education and expectation management, including informed consent, are comprehensively addressed. Systemic and ocular contraindications, as well as dry eye disease and Meibomian gland dysfunction, are also discussed.
Common complications and side effects are listed, including both corneal and lens-related issues. The importance of surgeon experience is emphasized.
In summary, the refractive surgery guidelines serve as a clinical tool rather than a legal standard. They promote high-quality, well-informed patient care. Future updates will follow emerging evidence, with patient-reported outcome measures (PROMs) and personalized approaches representing key directions for development.
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侯鈞賀 醫師Taiwan
Speaker
Safety Guidelines and Preoperative Assessment for Refractive Surgery: Challenges in High Myopia and Corneal Risk FactorsRefractive surgery has evolved substantially over the past decade, offering increasingly precise and predictable outcomes. Yet, ensuring patient safety—particularly in individuals with high myopia or underlying corneal risk factors—remains a core responsibility in clinical decision-making. This presentation provides an updated, evidence-based overview of safety guidelines and preoperative assessment strategies essential for optimizing refractive surgery outcomes.
We will begin by reviewing current standards for evaluating refractive stability, corneal biomechanics, epithelial thickness mapping, and posterior elevation indices. Special emphasis will be placed on the identification of subclinical keratoconus and forme-fruste ectasia, conditions that significantly elevate the risk of postoperative corneal ectasia. Practical screening algorithms—including integration of tomography, biomechanical testing, and individualized risk calculators—will be discussed to support accurate risk stratification.
High myopia presents unique challenges, including thinner corneas, greater ablation depth requirements, and a potentially higher susceptibility to biomechanical decompensation. The talk will highlight recent data on surgical candidacy thresholds, residual stromal bed safety margins, and considerations for choosing between LASIK, PRK, SMILE, or phakic IOL implantation in this population. Case-based examples will illustrate real-world pitfalls and decision-making nuances encountered in screening high-risk patients.
Finally, updated consensus recommendations and emerging technologies for improving preoperative detection and enhancing surgical safety will be summarized. By reinforcing rigorous assessment protocols and individualized risk evaluation, this presentation aims to support ophthalmologists in delivering safer, more predictable refractive surgery outcomes for patients with high myopia and complex corneal profiles.
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Moderator
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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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Moderator
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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.
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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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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呂宥萱 醫師Taiwan
Speaker
Innovation in KLEx SurgeryKeratorefractive Lenticule Extraction (KLEx) continues to evolve as a leading minimally invasive approach for corneal refractive correction. Among emerging technologies, Johnson & Johnson Vision’s Smooth Incision Lenticule Keratomileusis (SILK) represents a significant advancement within the KLEx family by addressing key limitations of earlier lenticule-based procedures. SILK is engineered around three core innovations: exceptionally low pulse energy, smooth continuous dissection, and a biconvex lenticule design.
SILK operates at an ultralow pulse energy of approximately 50 nJ, one of the lowest among current refractive laser platforms. This reduced energy delivery minimizes collateral stromal disruption, promotes cleaner interface quality, and may decrease postoperative inflammation. Complementing this, SILK utilizes a smooth, continuous dissection pattern that creates highly uniform cleavage planes. This design facilitates gentle lenticule separation and extraction through a micro-incision, reducing mechanical stress on the cornea and supporting rapid early visual recovery.
A further distinguishing feature is the biconvex lenticule configuration, which improves its natural conformability to the stromal bed and reduces interface mismatch. This enhanced anatomical fit may help preserve subbasal corneal nerves during tissue creation and extraction, thereby lowering the risk of postoperative dry eye symptoms and supporting overall ocular surface health.
Together, these innovations position SILK as a refined next-generation KLEx technique with strong potential in clinical practice. Ongoing investigations comparing the strengths and limitations of different KLEx approaches will continue to guide technique optimization, with the ultimate goal of providing patients with the safest and most effective refractive surgical outcomes.
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歐又齊 醫師Taiwan
Speaker
KLEx Surgery Procedure & TipsKLEx surgery mainly includes procedures such as SMILE, SMILE Pro, and SILK. In essence, these surgical techniques are quite similar. However, to further reduce surgical time and enhance patient comfort and satisfaction, we can incorporate certain refinements and add small but effective techniques to our own surgical workflow. In this discussion, I will share some of my personal experiences before, during, and after surgery—specifically, how I optimize each step to achieve a smoother procedure and better postoperative outcomes.
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陳南妮 醫師Taiwan
Speaker
Prepared and Ready for Your First Refractive SurgeryEvidence-based recommendations for KLEx in clinical practice
-preoperative screening for keratoconus
-surgical planning
-management and prevention of complications and infection.
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馬惠康 醫師Taiwan
Moderator
Cultivated Oral/Nasal Mucosal Epithelial Sheets for Ocular Surface Reconstruction in TaiwanBackground
To investigate the in vivo epithelial phenotypes of cultivated nasal mucosal epithelial cell (CUNMEC) sheets generated by a microspheroidal suspension culture technique.
Methods
Human nasal mucosal tissues were obtained during DCR. The tissues were digested with 2 mg/mL collagenase A, then the cell aggregates were seeded onto a de-epithelialized AM and cultivated for 2 weeks. The CUNMEC sheets were then transplanted into New Zealand albino rabbits. The animals were subjected to immunosuppression for two weeks and then sacrificed. The samples were subjected to light and electron microscopy (EM) and immunoconfocal microscopy examinations.
Results
The presence of CUNMECs in rabbit eyes was confirmed by anti-human cytoplasmic
antibody staining. Keratins 3, 4, and 13 were positively expressed in the suprabasal
region, whereas p63 expression was observed only in the basal layer. Transmission
EM revealed stratified epithelium with the formation of desmosomes and
hemidesmosomes. Scanning EM revealed a cobble stone-like epithelial surface
without cilia formation. α-Tubulin, a major component of cilia, was expressed only in
the apical region of the nasal mucosa and showed diffuse cytoplasmic staining in the
CUNMEC sheets. ZO-1, a component of tight junctions, was expressed in the apical
region of the nasal mucosa and was expressed at intercellular borders in CUNMECs.
Conclusion
Following transplantation, the CUNMEC sheet presented a stratified epithelial layer
containing GCs but without cilia and expressed progenitor cell markers, which are
morphologically similar to those of ocular surface epithelia and may have the potential to function as a surrogate epithelium for ocular surface reconstruction, especially in dry eye conditions.
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萬懿 醫師Taiwan
Speaker
From Preoperative Findings to Procedure Choice: A Practical Overivew of Corneal and Intraocular Refractive SurgeryThe outcome of refractive surgery is closely tied to how well patients are evaluated before surgery. This talk will give a practical overview of how preoperative findings help guide the choice between corneal and intraocular refractive procedures, drawing on the insights from recent literature.
Topics include ocular surface condition, corneal biomechanics, and optical quality. Special attention will be given to findings that may limit certain procedures, such as severe dry eye, corneal dystrophy or degeneration, significant high-order aberrations, unstable biomechanics, nystagmus, previous enhancement, systemic disease, and large angle kappa.
Age, refractive range, and lifestyle factors also play a role in deciding between corneal laser surgery and intraocular options like phakic or pseudophakic IOLs. The aim is to share a clear, clinically useful approach for safer and more individualized refractive surgery planning.
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陳弘誌 醫師Taiwan
Speaker
Intra OP & Post OP Complication Management in Corneal Refractive SurgeryCorneal refractive surgery has evolved significantly with modern laser platforms, diagnostic technologies, and surgical techniques, offering high safety, predictability, and patient satisfaction. Despite advancements, intraoperative and postoperative complications remain critical determinants of visual outcomes, warranting prompt recognition and evidence-based management. This review highlights key complication profiles and practical strategies for optimized peri-operative care in refractive procedures, including PRK, LASIK and KLEx.
Intra-OP complications in corneal laser surgery primarily involve flap-related issues in LASIK (incomplete, irregular, free, or displaced flaps), docking or suction loss in femtosecond platforms, and interface problems. In KLEx, challenges include suction loss, black spots, cap perforation, retained lenticule fragments, incision tearing, and extraction difficulty. Immediate management strategies emphasize maintaining tissue integrity, minimizing further manipulation, and appropriate surgical abort or conversion when indicated.
Post-OP adverse events may include dry eye disease, epithelial ingrowth, diffuse lamellar keratitis (DLK), infection, corneal haze, ectasia, residual refractive error, night vision disturbances, and elevated intraocular pressure. Management requires a tailored approach, such as aggressive lubrication and anti-inflammation support for ocular surface disease, early steroid escalation for haze and DLK, interface washout for progressive ingrowth, corneal cross-linking for biomechanical instability, and enhancement surgery when refractive targets are unmet. Regular monitoring via corneal tomography, epithelial mapping, and wavefront analysis aids early detection and intervention.
A structured management algorithm, proactive risk assessment, surgeon experience, and patient-specific optimization remain essential to achieving safe, sustainable refractive outcomes and minimizing long-term morbidity.
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胡鴻琳 醫師Taiwan
Speaker
Preoperative Tomographic and Biomechanical Corneal Assessment for Refractive SurgerySummary
Appropriate patient selection remains fundamental to safe refractive laser surgery. Corneal tomography and corneal biomechanics are central to identifying early ectatic changes and biomechanical vulnerability.
Tomography offers a 3-dimensional assessment of anterior and posterior corneal surfaces, enabling detection of subtle keratoconus and other contraindications. Key parameters such as posterior elevation patterns and pachymetric distribution help quantify ectasia risk.
Corneal biomechanics, assessed with technologies like the Corvis ST or ORA, provide direct measurements of tissue stability. Metrics including deformation amplitude and corneal stiffness can uncover susceptibility to postoperative ectasia, even when tomography findings are within normal limits.
Integrating both modalities improves preoperative risk stratification, enhances surgical safety, and supports more individualized refractive planning.
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姚克 Yao KeChina
Speaker
Adances in FLACS Cataract surgery in China has experienced a profound transformation, evolving from traditional practices
to the implementation of advanced techniques like Femtosecond Laser-Assisted Cataract Surgery
(FLACS). This lecture provides an overview of the recent clinical research in Mainland China, focusing on
optimizing surgical workflows, refining patient selection criteria, and evaluating visual and refractive
outcomes associated with FLACS. Data from these studies have contributed to evidence-based protocols
that support the safe and effective implementation of laser-assisted cataract procedures across diverse
clinical settings.
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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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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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孫興懷 醫師China
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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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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Vicente OcampoPhilippines
Speaker
Ocular TB: The Philippine Experience This talk aims to discuss the fine points in bringing people together to work towards achieving a common goal. It will identify the roles of an effective leader and will differentiate transactional from transformational leadership. It will also tackle the essential elements to a successful endeavor namely - Vision, Resolve, Strategy and People.
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Muiz MAHYUDINMalaysia
Speaker
Presbyopic Correction with LVC This lecture will explore the viability of laser vision correction (LVC) for presbyopia, focusing on the concepts of presby-LASIK, multifocal ablations, and blended vision strategies. We will discuss the optical compromises inherent in these approaches, such as reduced contrast sensitivity and the occurrence of halos, before reviewing current evidence on outcomes, patient satisfaction, and reported side effects. Clinical cases will be highlighted to illustrate practical applications and challenges in patient selection and counseling. Finally, we will evaluate the balance between the future potential of these techniques and their current limitations, enabling participants to describe the key surgical methods and critically appraise the available evidence regarding efficacy and safety.
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謝宜靜 醫師Taiwan
Speaker
SMILE: Journeys for Patients and SurgeonsSmall-incision lenticule extraction (SMILE), a keratorefractive lenticule extraction (KLEx) procedure, has been performed using the VisuMax femtosecond laser for more than 10 years. The VISUMAX 800 femtosecond laser is the latest upgrade to the SMILE platform. The major improvement is the laser application time. Studies of SMILE with VISUMAX 800 showed equivalent visual outcomes for treating myopia with astigmatism while comparing to VISUMAX 500. However, overall satisfaction of patients and surgeons may be different. Optimize the procedure and extend the clinical applications are still in process.
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林浤裕 醫師Taiwan
Speaker
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。
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梁章敏 醫師Taiwan
Speaker
From Precision to Patient Satisfaction: Clinical Outcomes with SCHWIND ATOS SmartSightThe SCHWIND ATOS femtosecond laser system, incorporating SmartSight technology, represents a new generation of minimally invasive refractive surgery designed to enhance both surgical precision and patient satisfaction. Unlike traditional lenticule extraction platforms, ATOS combines a fast scanning speed with advanced eye-tracking, centration control, and energy modulation algorithms, enabling smoother lenticule interfaces and improved corneal biomechanical preservation.
This prospective study evaluated the visual and refractive outcomes of myopia and myopic astigmatism correction performed with the SCHWIND ATOS. A total of 120 eyes from 60 patients were enrolled and followed for 6 months. Postoperative uncorrected distance visual acuity (UDVA) reached 20/20 or better in 94% of eyes, while 98% were within ±0.50 D of the intended correction. Contrast sensitivity and higher-order aberration profiles demonstrated significant improvement compared with preoperative values. No intraoperative complications or visually significant postoperative haze were observed.
Beyond optical performance, patient satisfaction was assessed through a standardized questionnaire addressing visual comfort, dryness, and night vision quality. Over 90% of patients reported high satisfaction with visual clarity and minimal postoperative discomfort.
In conclusion, SCHWIND ATOS SmartSight achieves predictable refractive outcomes with excellent safety and stability while preserving corneal biomechanics. Its precision, smooth lenticule quality, and optimized patient experience position ATOS as a promising platform in the evolving landscape of lenticule-based refractive surgery.
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黃偉成 醫師Taiwan
Speaker
CLEAR Refractive Surgery with Smart Technology: Advancing Clinical OutcomesThis talk is divided into three parts. First, I will give a brief overview of the Ziemer Z8, a versatile femtosecond laser platform capable of performing femtosecond laser–assisted cataract surgery (FLACS), corneal procedures such as intracorneal ring segments (ICRS) and lamellar keratoplasty, as well as myopic correction with Keratorefractive Lenticule Extraction (KLEx). The Z8 is a compact, mobile system that can be moved between different operating rooms. However, in order to achieve this compact and portable design, it uses a rotating, vibrating handpiece, which is often the main barrier to acceptance for many surgeons.
In the second part, I will share our current clinical experience and outcome data with KLEx using this platform, to provide colleagues who are interested in this system with a more in-depth understanding.
Finally, I will introduce a major upcoming upgrade of the system, which will enable direct integration with a corneal topographer. With iris registration, this will allow automatic centration and automatic rotation for astigmatism correction.
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林丕容 醫師Taiwan
Moderator
Refractive Surgery of LVC and ICL for PresbyopiaUpdate the mainstream of Refractive Surgery Including LVC and ICL for presbyopia
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林丕容 醫師Taiwan
Speaker
Refractive Surgery of LVC and ICL for PresbyopiaUpdate the mainstream of Refractive Surgery Including LVC and ICL for presbyopia
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Thomas KOHNENGermany
Speaker
Power and Precision: The New Era of Phacoemulsification TechnologyModern phacoemulsification technology has evolved into a precise, efficient, and customizable system that supports both standard cataract surgery and refractive visual outcomes. Contemporary devices integrate intelligent fluidics, responsive energy delivery, and enhanced intraoperative control, aiming to improve safety and reduce corneal trauma. Femtosecond laser platforms contribute by standardising capsulotomies, fragmenting the nucleus, and enabling astigmatism-neutral corneal incisions, which supports predictable refractive results and facilitates the use of advanced IOL designs. Astigmatism management remains central to postoperative quality, with digital marking systems improving axis alignment and complementing toric IOL implantation. Sustainability is gaining relevance as reusable tubing, cassettes, and blades reduce environmental burden without compromising safety. Across these domains, innovation focuses on precision, patient-centred refractive planning, and resource-conscious implementation. The new era of phacoemulsification combines technological refinement, optical optimisation, and sustainable strategy to advance cataract surgery outcomes.Bridging Cornea and Lens: The Modern Role of Phakic IOLs in a Myopic WorldPhakic intraocular lenses provide a valuable refractive option for patients with myopia extending beyond the safe limits of corneal laser procedures. Positioned either in the anterior or posterior chamber, they preserve the natural crystalline lens and maintain corneal structure, making them particularly suitable when optical quality, contrast vision, or biomechanical stability must be prioritised. Current guidelines support their use from low to high myopic ranges, with toric designs enabling simultaneous astigmatism correction. Compared with laser-based approaches, phakic IOLs deliver strong visual performance and high patient satisfaction, especially in moderate and high myopia. Long-term outcomes highlight the need for monitoring endothelial cell behaviour and cataract formation as part of routine follow-up. When cataract develops later in life, bilensectomy combines IOL explantation with cataract surgery to preserve refractive goals. Phakic IOLs bridge the space between corneal and lenticular refractive strategies and remain central in modern myopia management.From Awareness to Action: Stepwise Learning to Manage Capsular Rupture During Cataract SurgeryPosterior capsular rupture remains a decisive intraoperative challenge during cataract surgery, most often occurring during lens removal, cortical aspiration, or IOL implantation. Successful management requires early recognition, maintenance of chamber stability, and prevention of nuclear descent into the vitreous. This work presents a structured escalation strategy guiding surgeons from awareness of risk factors to practical intervention. Key steps include controlled viscoelastic support, careful manipulation of remaining lens material, and appropriate anterior or pars plana vitrectomy when vitreous prolapse occurs. IOL selection must be adapted to capsular integrity, allowing placement in the bag when stable or in the sulcus with or without optic capture when support is limited; alternative fixation methods remain essential fallback options. Case examples illustrate that even multifocal IOL implantation is achievable despite rupture if capsular support is preserved and decision-making remains systematic. The stepwise approach aims to enhance intraoperative safety, reduce complication impact, and preserve refractive goals in modern cataract surgery.
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David HuangUnited States
Speaker
OCT/OCTA Application in the Anterior SegmentOptical coherence tomography (OCT) applications in the anterior segment have lagged retinal
imaging because of the wider area and deeper structures that need to be covered, including the
cornea, anterior chamber, and crystalline lens. With recent advances in the speed and depth
range of both spectral-domain and swept-source OCT has finally hit the mainstream with many
products reaching the market in the past 5 years. Compared to Placido-disc and Scheimpflug
slit-scanning technologies, OCT offers higher depth resolution and the ability to map epithelial
thickness as well as pachymetry, anterior topography, and posterior topography. This lecture will
describe how this can be used to detect and differentiate among the major classes of corneal
diseases. Other topics that will be covered include wide-field OCT for corneoscleral topography,
OCT microscopy to see cells and pathogens, OCT biometry for intraocular lens calculations, and
OCT angiography for the evaluation of iris and ocular surface tumors.Seeing Small and Aiming Big: the Development and Clinical Impact of Optical Coherence TomographyOptical coherence tomography (OCT) is a technology invented in 1991 to image small critical tissue
structures with micrometer resolution. It is widely used in eye and coronary heart diseases. I will
tell the story of OCT’s initial conception from the inventor’s perspective along with an account of
the rapid pace of development that made OCT a clinical reality. The biggest applications of OCT in
the management of eye diseases will be shown. Recent advances that enable OCT to advance
beyond the imaging of tissue structure to the detection of blood flow and photoreceptor function
will be described. The roles of academia, industry, and government agencies in the clinical
translation of OCT will be highlighted.
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陳偉勵 醫師Taiwan
Speaker
Using AS-OCT with epithelial thickness mapping and a self-developed stromal thickness map to detect early corneal ectasia and prevent postoperative ectasia following refractive surgeryEarly detection of subclinical corneal ectasia remains one of the most critical challenges in managing ophthalmic diseases and performing modern corneal refractive surgery. Advances in anterior segment optical coherence tomography (AS-OCT) have enabled highly detailed assessment of corneal microstructure, particularly through epithelial thickness mapping, which often reveals subtle compensatory remodeling before stromal abnormalities become clinically apparent. In this study and clinical application series, we introduce—and precisely apply—epithelial thickness mapping together with our team’s newly developed **corneal stromal thickness difference map** to further enhance the sensitivity of ectasia screening.
This lecture summarizes our team’s recently published work as well as upcoming research, with a focus on how these innovative imaging approaches allow for **early detection of corneal ectasia**, even before topographic changes emerge. Our difference map quantifies disparities between epithelial masking patterns and stromal surface alterations, enabling clinicians to identify early biomechanical instability that is often invisible on conventional topography or tomography.
Through this presentation, attendees will gain a deeper understanding of the latest clinical applications of AS-OCT epithelial mapping and how these advanced tools can be integrated into routine practice to more effectively detect, manage, and prevent hidden or subclinical corneal ectasia. These innovations provide additional structural insight that supports more accurate refractive surgical planning and contributes to improved long-term corneal stability.
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Shigeru KinoshitaJapan
Speaker
Toward Corneal Regenerative MedicineSevere ocular surface and corneal disorders—including Stevens-Johnson syndrome, chemical injury, ocular cicatricial pemphigoid, Fuchs endothelial corneal dystrophy (FECD), and advanced corneal endothelial failure—remain difficult to manage. Recent advances in ocular surface biology and regenerative medicine have enabled the development of transplantable epithelial sheets, such as allogeneic/autologous corneal epithelial stem-cell sheets, autologous cultivated oral mucosal epithelial sheets (COMET), and iPSC-derived corneal epithelial sheets, some of which have received regulatory approval from the EMA and PMDA.
Corneal endothelial dysfunction is also being addressed through regenerative medicine approaches. The transplantation (via injection) of mature, differentiated cultured human corneal endothelial cells (CHCEC) combined with a ROCK inhibitor into the anterior chamber has demonstrated favorable efficacy and safety, leading to PMDA approval in 2023 and subsequent clinical application in Japan beginning in September 2024. In addition, ROCK-inhibitor eye drops have demonstrated potential in treating early-stage endothelial dysfunction in FECD.
Continued progress in corneal regenerative therapies promises to advance global regulatory acceptance and contribute meaningfully to the prevention of blindness worldwide.
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Shigeru KinoshitaJapan
Speaker
Toward Corneal Regenerative MedicineSevere ocular surface and corneal disorders—including Stevens-Johnson syndrome, chemical injury, ocular cicatricial pemphigoid, Fuchs endothelial corneal dystrophy (FECD), and advanced corneal endothelial failure—remain difficult to manage. Recent advances in ocular surface biology and regenerative medicine have enabled the development of transplantable epithelial sheets, such as allogeneic/autologous corneal epithelial stem-cell sheets, autologous cultivated oral mucosal epithelial sheets (COMET), and iPSC-derived corneal epithelial sheets, some of which have received regulatory approval from the EMA and PMDA.
Corneal endothelial dysfunction is also being addressed through regenerative medicine approaches. The transplantation (via injection) of mature, differentiated cultured human corneal endothelial cells (CHCEC) combined with a ROCK inhibitor into the anterior chamber has demonstrated favorable efficacy and safety, leading to PMDA approval in 2023 and subsequent clinical application in Japan beginning in September 2024. In addition, ROCK-inhibitor eye drops have demonstrated potential in treating early-stage endothelial dysfunction in FECD.
Continued progress in corneal regenerative therapies promises to advance global regulatory acceptance and contribute meaningfully to the prevention of blindness worldwide.
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馬惠康 醫師Taiwan
Speaker
Cultivated Oral/Nasal Mucosal Epithelial Sheets for Ocular Surface Reconstruction in TaiwanBackground
To investigate the in vivo epithelial phenotypes of cultivated nasal mucosal epithelial cell (CUNMEC) sheets generated by a microspheroidal suspension culture technique.
Methods
Human nasal mucosal tissues were obtained during DCR. The tissues were digested with 2 mg/mL collagenase A, then the cell aggregates were seeded onto a de-epithelialized AM and cultivated for 2 weeks. The CUNMEC sheets were then transplanted into New Zealand albino rabbits. The animals were subjected to immunosuppression for two weeks and then sacrificed. The samples were subjected to light and electron microscopy (EM) and immunoconfocal microscopy examinations.
Results
The presence of CUNMECs in rabbit eyes was confirmed by anti-human cytoplasmic
antibody staining. Keratins 3, 4, and 13 were positively expressed in the suprabasal
region, whereas p63 expression was observed only in the basal layer. Transmission
EM revealed stratified epithelium with the formation of desmosomes and
hemidesmosomes. Scanning EM revealed a cobble stone-like epithelial surface
without cilia formation. α-Tubulin, a major component of cilia, was expressed only in
the apical region of the nasal mucosa and showed diffuse cytoplasmic staining in the
CUNMEC sheets. ZO-1, a component of tight junctions, was expressed in the apical
region of the nasal mucosa and was expressed at intercellular borders in CUNMECs.
Conclusion
Following transplantation, the CUNMEC sheet presented a stratified epithelial layer
containing GCs but without cilia and expressed progenitor cell markers, which are
morphologically similar to those of ocular surface epithelia and may have the potential to function as a surrogate epithelium for ocular surface reconstruction, especially in dry eye conditions.
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