Matteo Piovella

Matteo Piovella, MD, is an internationally acclaimed cataract and refractive surgery expert and has a private practice at Global Center for Ophthalmology in Monza (Milan), Italy. piovella@piovella.com Dr Piovella is the President of the Italian Ophthalmological Society – SOI, (2010/2027) an institution that represents the 7000 Italian eye doctors. He is the recipient of the highest international awards for cataract and refractive surgery. Dr Piovella has been sharing his experience with eye doctors worldwide, having taught in 278 Instruction Course Programs organized as Senior Instructor held during various esteemed international meetings. (AAO AECOS APACRS APAO ASCRS ESCRS IIIC SOE) Through these international meetings, he has performed 150 live surgery demonstrations to share his knowledge and innovative techniques in the field of cataract and refractive surgery. His scientific studies have generated 809 scientific paper presentations. His major interest is spreading Refractive Cataract Surgery in the world. Since 2018 over 95% of his cataract patients underwent surgery with Trifocal IOL implantation. He identified the essential role of advance biometry in achieving the perfect correction of visual defects and presbyopia after cataract surgery and formulated in 2023 indications, the MAPRY protocol, to treat Evaporative Dry Eye and MGD. This protocol is now applied to all candidate for refractive cataract and refractive surgery.

Day 1 Saturday - 13 Dec 2025

Time Session
08:30
12:00
EN
  • Thomas KOHNENGermany Moderator Power and Precision: The New Era of Phacoemulsification TechnologyBridging Cornea and Lens: The Modern Role of Phakic IOLs in a Myopic WorldFrom Awareness to Action: Stepwise Learning to Manage Capsular Rupture During Cataract Surgery
  • 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.
  • 盧兆功 Chao-Kung LuTaiwan Speaker Divide and Conquer: Establishing a Stable Foundation for BeginnersThe divide and conquer technique is the fundamental method that every cataract surgeon begins their training with. The divide and conquer phacoemulsification technique involves several steps. First, a proper capsulorhexis and excellent hydrodissection are performed to ensure the nucleus can be rotated freely. Next, the surgeon creates a deep groove and then cracks the nucleus into four quadrants. Finally, the nucleus is emulsified and aspirated piece by piece. Pearls for this method include deeply debulking the nucleus before cracking, ensuring all pieces are broken up before removal to facilitate easier rotation and extraction, and having strategies for managing both soft and hard cataracts.
  • 簡湘文 Hsiang-Wen ChianTaiwan 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.
  • 莊智鈞 Chih-Chun ChuangTaiwan 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.
  • Moderator
  • Thomas KOHNENGermany Speaker Power and Precision: The New Era of Phacoemulsification TechnologyBridging Cornea and Lens: The Modern Role of Phakic IOLs in a Myopic WorldFrom Awareness to Action: Stepwise Learning to Manage Capsular Rupture During Cataract Surgery
  • 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.
  • 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.
  • 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.
  • 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.
  • 王元聖 Yuan-Shen WangTaiwan 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.
  • Moderator
  • 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.
  • 賴俊杰 Chun-Chieh LaiTaiwan Speaker Trends and Market Share of Presbyopia-Correcting Intraocular Lenses in Taiwan & Asia In this section, we will talk about the trends and market share of presbyopia-correcting intraocular lenses in Taiwan and Asia.Minimize Further Dehiscence of Zonules in Patients with Large Zonular Weakness Zonular weakness increases the likelihood of dealing with complicated cataract surgery and encountering postoperative complications. These risks include intra- and postoperative complications from cataract surgery, such as posterior capsular rupture, vitreous loss, and lens dislocation and decentration. Common risk factors for weak zonules are pseudoexfoliation syndrome, mature cataracts, high myopia, Marfan syndrome, and prior ocular surgery. Signs of weak zonules include iridodonesis, phacodonesis, abnormal anterior chamber depth or asymmetry, angle asymmetry on gonioscopy, and vitreous in the anterior chamber. Zonular dehiscence and lens subluxation or dislocation can be seen in advanced zonulopathy. But most of the time, weak zonules may not be noticed until after the surgery has begun. Intraoperative signs of weak zonules include anterior chamber depth fluctuation, difficulty puncturing the anterior lens capsule, star-shaped striae on the capsule surface during the capsulorhexis, lens movement when manipulations, and difficulty in rotating the nucleus within the capsular bag despite adequate hydrodissection. In this video discussion, we will talk about how to minimize further dehiscence of zonules in patients with large zonular weakness during operation and make the cataract surgery safer.
  • Moderator
  • 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.
  • 侯鈞賀 Chiun-Ho HouTaiwan 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.
  • Moderator
  • 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.
  • Moderator
  • 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.
  • 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.
701C
14:30
17:30
EN
  • 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.
  • 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
  • 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.
  • 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.
  • 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.
  • Bożena Romanowska-DixonPoland Speaker Practical aspects of diagnosis and treatment of intraocular metastases
  • Muhammad Bayu SasongkoIndonesia Speaker Transforming DR Care in Indonesia
  • 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.
  • 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.
701B

Day 2 Sunday - 14 Dec 2025

Time Session
08:00
12:00
EN
  • 潘志勤 Chih-Chin PanTaiwan Moderator 眼科醫師在校園視力保健及公共衛生推廣中的角色摘要 眼科醫師在校園視力保健及公共衛生推廣中,扮演著遠超過「診療者」的多元且關鍵角色。他們是整個視力保健體系中的專家、倡議者、教育者與把關者。 眼科醫師在此領域中的多重角色: 一、 校園視力保健中的直接角色 在校園這個第一線場域,眼科醫師的角色從被動治療轉為主動出擊。 二、 公共衛生推廣中的核心角色 在更宏觀的公衛層面,眼科醫師是政策與民眾之間的橋樑,是推動全民視覺健康的引擎。 總結 眼科醫師在校園視力保健與公衛推廣中的角色,已從傳統的「醫療端」向前延伸至「預防端」和「政策端」。對於提升整體國民的視覺健康與生活品質,及一個國家的公共衛生和發展至關重要。
  • 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.
  • Prin RojanapongpunThailand Speaker Intraoperative Aberrometry: Benefits or Distractions?Intraoperative Aberrometry (IA) is a microscope-mounted aberrometer that uses a laser wavefront analyzer to provide an intraoperative refractometer with live measurement. IA utilizes real-time wavefront analysis to measure IOL power in the aphakic state (after I&A but before IOL implantation), guiding Toric IOL axis alignment, and confirming final refraction in the pseudophakic stage (after IOL implantation). IA serves as an IOL power verification process by providing aphakic measurements. IA has demonstrated improved accuracy compared to preoperative biometry and is most beneficial in complex cases, including post-refractive surgery eyes, eyes with uncertainty in preoperative biometry, and cases involving premium and toric IOL implantation, which results in less postoperative residual astigmatism. IA accuracy is highly dependent on meeting specific intraoperative conditions. Erroneous measurements can occur due to factors like eyelid squeezing, speculum pressure, eye position/fixation, abnormal eye pressure, media conditions (OVD type and refractive index), corneal status, small pupil size, and IOL specifics. Caution is recommended when IA readings disagree significantly with preoperative measurements (e.g., a vector difference of 0.5 D in cases of low astigmatism). Conclusion: Intraoperative Aberrometry is beneficial, especially for eyes with abnormal axial length, prior refractive surgery, toric IOLs, multifocal lenses, or uncertain biometry. IA functions as an additional measurement and verification tool. While IA can be beneficial when the surgeon masters the technique and all variables are optimized, it could be a distraction if optimization is not met.
  • 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
  • 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.
  • Thomas KOHNENGermany Speaker Power and Precision: The New Era of Phacoemulsification TechnologyBridging Cornea and Lens: The Modern Role of Phakic IOLs in a Myopic WorldFrom Awareness to Action: Stepwise Learning to Manage Capsular Rupture During Cataract Surgery
  • Justin SherwinAustralia Speaker Two Eyes, One Day: The Evolving Landscape of Immediate Sequential Cataract SurgeryImmediate bilateral sequential lens-based surgery is increasingly adopted as a safe, effective, and patient-centred option for cataract and lens-based refractive procedures. This presentation reviews recent evidence on epidemiology, practice patterns, and outcomes across cataract surgery, refractive lens exchange, and phakic IOL implantation. Studies demonstrate high efficacy in achieving refractive targets, rapid recovery of binocular vision, and consistent improvements in quality of life. Advances in biometry, surgical technology, and IOL design have further enhanced predictability and safety. Safety remains central, with very low rates of bilateral complications when established risk-reduction protocols—separate instrumentation, asepsis, and adherence to guidelines—are followed. Comparisons with delayed sequential surgery show equivalent visual and refractive outcomes, along with reduced healthcare burden. This session will highlight current evidence on efficacy, safety, visual and refractive outcomes, and patient-reported benefits, while considering future directions in the expanding role of immediate bilateral sequential lens-based surgery.
  • 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.
  • Marco FantozziItaly Speaker Intracorneal Implants in the Cataract Age: Expanding Vision Beyond LensesIntracorneal Implants in the Cataract Age: Expanding Vision Beyond Lenses Introduction: Intracorneal implants were developed as an additive, minimally invasive, and removable approach to address presbyopia and loss of accommodation. Designed to complement rather than replace existing ocular structures, they can be used in near-emmetropic eyes or combined with laser refractive procedures and monofocal intraocular lenses (IOLs) for pseudophakic patients. This study aimed to evaluate the long-term outcomes of combined cataract surgery and intracorneal microlens implantation
  • 許粹剛 Tsui-Kang HsuTaiwan Speaker When the Capsule Gives Way: Winning the Posterior Rupture BattleCataract surgery is the most commonly performed operation in ophthalmology and despite tremendous instrumental and technological advancements, posterior capsular rupture (PCR) still occurs. PCR occurs both in all eye surgeons, although with a higher frequency in the newer starter group. Additionally, certain types of cataracts are prone to this development. If handled properly in a timely method, the eventual outcome may be no different from that of an uncomplicated case. However, improper management may lead to serious complications with a higher incidence of permanent visual impairment. The speech disclose the management of PCR from two perspectives: 1. Identifying patients with higher risk and know the sign of early PCR, and measures to manage such patients by surgical maneuver, and 2. Intraoperative management of posterior capsular rupture with anterior vitrectomy with different setting and various case scenarios to prevent further long-term complications. Solution for Residual Large Lens Material with PCRCompromise of the posterior capsule can occur in the hands of both new and experienced surgeons. Learning how to prevent, avoid, or efficiently manage posterior capsular rupture (PCR) is important. If PCR is present with residual lens material and vitreous loss, it is important to disentangle the vitreous from any nuclear/cortical fragments to ensure their safe removal without creating vitreous traction in case of retinal detachment. The vitreous can be stained by using preservative-free triamcinolone to delineate its presence in the anterior chamber and any incarceration in the wound. Anterior vitrectomy can be performed to remove the vitreous from the anterior segment properly. Alternatively, suppose the surgeon is comfortable with a pars plana approach which is better route. In that senario, a pars plana vitrectomy can be done, which helps to pull the vitreous back to the posterior segment, and avoids excessive anterior chamber manipulation. The pars plana approach may also permit better access to residual lens material—the vitrector may be used to clear nuclear and cortical material with a change in settings. At the end of the case, the wounds should be checked carefully to ensure no vitreous is present. A suture or more if necessary, depending on wound size, should be placed at the primary wound. Pupillary miosis should be done to inspect the pupil. If the pupil is peaked, there is likely vitreous still present in the anterior chamber and possibly in the wound. Once the vitreous is adequately cleared, one may carefully resume phacoemulsification and insert an IOL in various methods.
  • 許詠瑞 Yung-Ray HsuTaiwan Speaker Loose Zonules, Steady Hands: Saving the Unstable LensZonular dehiscence with vitreous prolapse represents one of the most challenging scenarios in cataract surgery. This case involves a 65-year-old female referred intraoperatively for severe temporal zonular dialysis extending 120° with vitreous prolapse into the anterior chamber. In such situations, initial management options depend on the degree of capsular support and the surgeon’s familiarity with the anterior or posterior segment approaches. Possible options include: (1) primary pars plana lensectomy and vitrectomy (PPLV) with Yamane double-needle intrascleral fixation of an IOL; (2) anterior vitrectomy with in-the-bag or supplemental scleral fixation of a one-piece IOL using sutures; (3) pars plana vitreous levitation–assisted phacoemulsification; or (4) use of hooks or rings to preserve capsular support for in-the-bag implantation. In this case, I stabilized the anterior capsule using iris retractors, performed a careful anterior vitrectomy, and completed a slow-motion phacoemulsification to minimize zonular stress. Following cortical cleanup, both an in-the-bag IOL and capsular tension ring (CTR) were successfully implanted. The patients visual acuity on postoperative day 1 was 0.9. This surgical video illustrates a practical surgical maneuver with controlled movements, vitreous management, and structural stabilization techniques that allow safe phacoemulsification even in the setting of profound zonular loss.Pattern and Distribution of Uveitis Etiologies in Taiwan: A Multi-Center Perspective Uveitis is a heterogeneous group of intraocular inflammatory disorders with diverse etiologies and variable regional patterns. To delineate the current epidemiologic landscape of uveitis in Taiwan, a nationwide multicenter retrospective study was conducted collaboratively by the Taiwan Ocular Inflammation Society. Newly diagnosed uveitis cases from July 2022 to June 2023 were collected from 15 tertiary referral centers across northern, central, southern, and eastern Taiwan. A total of 1,654 cases were analyzed. The mean age at onset was 49.5 ± 18.3 years, with nearly equal sex distribution (50.6% male). Anatomical classification includes anterior uveitis (64.3%), followed by panuveitis (22.4%), posterior uveitis (11.0%), and intermediate uveitis (2.3%). Etiologically, 43.6% were non-infectious, 23.5% infectious, and 32.9% undifferentiated. The leading non-infectious entities were HLA-B27/ankylosing spondylitis–related uveitis (15.4%), glaucomatocyclitic crisis (5.0%), and Vogt-Koyanagi-Harada syndrome (3.3%). Among infectious causes, herpetic anterior uveitis (7.7%), cytomegalovirus anterior uveitis (5.1%), and endogenous bacterial endophthalmitis (3.9%) predominated. This large-scale multicenter study represents the most comprehensive epidemiological overview of uveitis in Taiwan to date. The unique disease pattern and relevant diagnostic challenges will be analyzed in this talk.
  • 王孟祺 Meng-Chi WangTaiwan Speaker Blinded by White: Cracking the Mature Cataract Safely (Presentation and Discussion)This is an unusual white cataract with posterior synechiae and silicone oil in the vitreous cavity following previous retinal detachment surgery.Before starting the procedure, we noticed some emulsified silicone oil at the apex of the anterior chamber.I injected trypan blue through the side port to stain the anterior capsule, followed by OVD injection from the opposite angle to replace and remove the dye as well as the silicone oil.After using a flat needle to separate the posterior synechiae, four iris hooks were placed to enlarge the small, fixed pupil. Unfortunately, the initial staining was insufficient, so I performed a second capsule stain.At this point, wrinkles and fibrosis over the anterior capsule were noted, so I decided to use an MVR blade to create the initial cut for the CCC.The anterior capsule had thickened significantly, making it hard to tear. After several unsuccessful attempts to tear the anterior capsule with the CCC forceps, I switched to microscissors to complete the capsulorhexis as round as possible.Regrettably, it was not possible to complete the capsulorhexis on the opposite side, so I attempted to use the CCC forceps once more. Fortunately, I was finally able to complete the capsulorhexis, although it was quite small and irregular. Since the anterior capsule was quite thick, I was not concerned about causing a radial tear during hydrodissection.It was quite easy to rotate the nucleus afterwards.Since the nucleus was rock-hard, I attempted to use the stop-and-chop technique, initiated by a long and deep sculpting.If the sculpting is not deep enough, it will be difficult to crack and completely bisect the hard nucleus.Take your time and spread your phaco tip and second instrument along the trench, section by section.Afterwards, rotate the nucleus 90 degrees away. At the same time, the milkified cortex was floating outside the capsule.I buried the phaco tip as deep as possible into the center of the nucleus. This allowed me to hold the nucleus firmly and chop it vertically without detaching it from the phaco tip.After cracking the nucleus into smaller pieces, I was able to manage each piece within the central pupillary area safely and efficiently.It is important to separate the leathery tethering part of the posterior pole completely; otherwise, it will be difficult to keep the nucleus pieces under control. If you follow this principle and take your time, you will be able to complete emulsification safely and effectively within the limited space, with a CDE of only 18.77. Another surprise emerged after I cleaned the nucleus: I found a large central fibrotic plaque on the posterior capsule, with nearly no epinucleus or cortex remaining. Silicon oil was shiny behind the posterior capsule.In this situation, it’s impossible to perform primary posterior continuous curvilinear capsulorhexis (CCC); therefore, I decided to use a YAG laser to open the posterior capsule one month later.Following the injection of OVD into the capsular bag, an aspheric hydrophobic intraocular lens (IOL) was implanted smoothly.After removing the iris hooks, I used micro scissors to trim the redundant tags from the CCC margin.The entire procedure was completed with stroma hydration for the main wound and all side ports. We could notice the dense fibrotic plaque over the central axis during the slit lamp examination the day after surgery. However, the central visual axis could still become clear after YAG capsulotomy, and fundus photography could be taken beautifully.
  • 林純如 Chun-Ju LinTaiwan Speaker Post-Op Red Flag: Beating Inflammation or Infection?Cataract surgery is one of the most frequently performed ophthalmic procedures and is generally associated with excellent visual outcomes. However, postoperative inflammation or infection can still lead to serious complications if not promptly recognized and managed. Distinguishing routine postoperative inflammation from sterile hyper-inflammatory reactions or early infectious endophthalmitis remains a clinical challenge. Importantly, reviewing the patient’s past medical and ocular history is essential, as underlying conditions such as uveitis, autoimmune disease, or prior ocular surgeries can significantly increase the risk and severity of postoperative inflammatory responses. Typical postoperative inflammation usually presents within the first few days and responds effectively to topical corticosteroids and nonsteroidal anti-inflammatory medications. In contrast, red flag signs—such as severe ocular pain, rapid vision decline, hypopyon, fibrin formation, or marked anterior chamber reaction—should raise suspicion for infectious endophthalmitis and prompt urgent intervention. Risk factors including wound leak, retained lens fragments, vitreous loss, or systemic immunosuppression further heighten concern. When media opacity limits direct examination, imaging tools such as anterior segment OCT and B-scan ultrasonography may assist diagnosis. Additionally, evidence supports tailored anti-inflammatory regimens perioperatively. Early recognition, patient education regarding warning symptoms, and timely referral to specialized care are critical in preventing irreversible visual loss. By identifying subtle clinical cues and considering patient-specific risk factors, ophthalmologists can effectively differentiate inflammation from infection and safeguard postoperative visual outcomes.
  • 許聖民 Sheng-Min HsuTaiwan Speaker Pseudophakic Macular Edema: Stopping Vision Loss Before It StartsPseudophakic macular edema (Ervine-Gass syndrome) remains the most common cause of decreased visual acuity after uneventful cataract surgery. Previous study reported that 26.8% of eyes with pseudophakic macular edema did not recover 6/6 vision. Clinically significant pseudophakic macular edema impairing patients' vision is found in 1-2% of patients with its peak 6 weeks following surgery, but subclinical macular edema can be seen in about 30% of patients in FA and up to 40% in OCT. To date, there are no uniform recommendations for the treatment of pseudophakic macular edema. Therefore, I will present two cases of pseudophakic macular edema here and discuss the strategies for treatment.
  • 蔡翔翎 Shawn TsaiTaiwan Speaker Get the Things Right: Correction of IOL SubluxationDislocation of an intraocular lens (IOL) is an uncommon (0.2–3%) yet potentially serious complication, in which the IOL deviates from its normal anatomical position. It may arise from complicated cataract surgery, ocular trauma, previous vitreoretinal surgery, high myopia, or systemic or ocular conditions associated with zonular weakness. While mild cases may be observed initially, surgical intervention is usually required when significant visual symptoms occur. Various surgical techniques can be employed depending on the surgeon’s experience and the clinical scenario. In this presentation, I will demonstrate two approaches: the “twist-and-out” IOL removal and the “Yamane technique” for secondary IOL fixation. The advantages, limitations, and practical considerations of these techniques will also be discussed.
  • 簡克鴻 Ke-Hung ChienTaiwan Speaker End the Bad Luck: Strategies for Refractive SurpriseDr. Chien will discuss the phenomenon of refraction surprise following cataract surgery—a postoperative outcome in which the patient’s refractive result differs from the intended target. Despite significant advancements in biometry technology, intraocular lens (IOL) power calculation formulas, and surgical techniques, refractive unpredictability can still occur and remains a noteworthy challenge in contemporary cataract surgery. A variety of factors may contribute to refraction surprise, including inaccurate axial length measurement, corneal surface irregularities, posterior corneal astigmatism, unrecognized IOL tilt or decentration, and intraoperative issues such as capsular instability. Additionally, postoperative anatomical changes may further alter refractive outcomes. Recognizing risk factors early and ensuring meticulous preoperative assessment are essential. When refraction surprise does occur, management options depend on both the underlying etiology and the magnitude of refractive deviation. Strategies include corneal refractive enhancement, piggyback IOL implantation, IOL exchange, or non-surgical approaches such as updating spectacles or contact lenses. Through case discussions and surgical experience sharing, Dr. Chien will present practical methods for preventing, diagnosing, and managing this complication—ultimately enhancing patient satisfaction and improving visual outcomes.
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