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08:30
12:00
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ZH
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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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702
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14:30
17:30
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ZH
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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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