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08:30
12:00
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EN
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Thomas KOHNENGermany
Moderator
Power and Precision: The New Era of Phacoemulsification TechnologyBridging Cornea and Lens: The Modern Role of Phakic IOLs in a Myopic WorldFrom Awareness to Action: Stepwise Learning to Manage Capsular Rupture During Cataract Surgery
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Filomena RIBEIROPortugal
Speaker
Neuroadaptation in Premium IOL PatientsNeuroadaptation is a key determinant of visual success and satisfaction after implantation of premium intraocular lenses. This session will discuss how the brain adapts to new optical conditions created by simultaneous vision IOLs, integrating multiple focal points while minimising photic phenomena. Clinical data and patient-reported outcomes will illustrate the variability and time course of adaptation, highlighting the influence of IOL design and individual neural plasticity. Understanding and supporting neuroadaptation are essential to optimise outcomes and enhance patient experience with modern premium IOL technologies.ESCRS Multiformulas IOL Power Calculator AccuracyAccurate intraocular lens (IOL) power calculation remains a critical determinant of refractive outcomes following cataract surgery. The ESCRS IOL Calculator integrates modern formulas to improve prediction accuracy and support IOL selection across diverse biometric profiles. This lecture will review recent data assessing the performance of the ESCRS Calculator in comparison with individual formulas, focusing on its refractive predictability, consistency across axial lengths, and clinical usability.
Results from validation studies and real-world datasets will be presented, highlighting the calculator’s strengths and limitations, as well as its role in optimising outcomes in standard and challenging eyes. The session will also address practical considerations for integration into clinical workflow and the ongoing evolution of formula combinations as biometry and lens technology continue to advance.
Burkhard DickGermany
Speaker
ESCRS Cataract Guidelines RecommendationsThe ESCRS Cataract Guidelines represent a comprehensive and evidence-based framework designed to support cataract surgeons across Europe in delivering safe, effective, and consistent care. In this presentation, an overview of the most relevant recommendations will be provided as well as key updates based on the latest clinical evidence.
Drawing from robust literature reviews and expert consensus, the ESCRS Guidelines cover the full patient journey: from preoperative assessment and biometry, to surgical technique, IOL selection, intraoperative considerations, and postoperative care. Emphasis will be placed on areas of evolving practice (SV IOL and infection prophylaxis).
Background will be given on how the guideline development process was designed to ensure practical relevance while maintaining scientific rigor, and how implementation can be supported across diverse healthcare settings. The goal is not only to standardize best practices but also to allow flexibility where justified by patient needs or surgical complexity.
This talk aims to provide attendees with clear, actionable insights from the ESCRS Cataract Guidelines that can enhance surgical outcomes and support continuous quality improvement in cataract care.IOL Exchange in the Premium IOL Era: Challenges and SolutionsThe rise of simultaneous vision intraocular lenses (SV IOLs), including multifocal, extended depth of focus, and toric designs, has significantly expanded visual outcomes in cataract and refractive surgery. However, this progress has been accompanied by an increase in the complexity and frequency of postoperative patient dissatisfaction, leading to a higher demand for IOL exchange in select cases.
This presentation explores the unique challenges of IOL exchange in the era of SV IOL technologies. Key indications for explantation will be reviewed, including suboptimal visual quality, dysphotopsia, residual ametropia, and rotational instability. Emphasis will be placed on clinical decision-making, diagnostic precision, and the timing of intervention, particularly in light of evolving patient expectations. Surgical strategies for safe and effective explantation will be discussed.
In addition, the importance of careful patient selection, preoperative counseling, and enhanced biometric planning as critical factors in reducing the need for IOL exchange will be highlighted. Emerging technologies that may support more accurate IOL selection and customization will also be briefly introduced.
This talk aims to provide practical guidance for surgeons facing the growing demands of managing SV IOL complications and achieving optimal outcomes through safe exchange procedures.
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盧兆功 Chao-Kung LuTaiwan
Speaker
Divide and Conquer: Establishing a Stable Foundation for BeginnersThe divide and conquer technique is the fundamental method that every cataract surgeon begins their training with. The divide and conquer phacoemulsification technique involves several steps. First, a proper capsulorhexis and excellent hydrodissection are performed to ensure the nucleus can be rotated freely. Next, the surgeon creates a deep groove and then cracks the nucleus into four quadrants. Finally, the nucleus is emulsified and aspirated piece by piece. Pearls for this method include deeply debulking the nucleus before cracking, ensuring all pieces are broken up before removal to facilitate easier rotation and extraction, and having strategies for managing both soft and hard cataracts.
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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.
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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.
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Moderator
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Thomas KOHNENGermany
Speaker
Power and Precision: The New Era of Phacoemulsification TechnologyBridging Cornea and Lens: The Modern Role of Phakic IOLs in a Myopic WorldFrom Awareness to Action: Stepwise Learning to Manage Capsular Rupture During Cataract Surgery
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姚克 Yao KeChina
Speaker
Adances in FLACS Cataract surgery in China has experienced a profound transformation, evolving from traditional practices
to the implementation of advanced techniques like Femtosecond Laser-Assisted Cataract Surgery
(FLACS). This lecture provides an overview of the recent clinical research in Mainland China, focusing on
optimizing surgical workflows, refining patient selection criteria, and evaluating visual and refractive
outcomes associated with FLACS. Data from these studies have contributed to evidence-based protocols
that support the safe and effective implementation of laser-assisted cataract procedures across diverse
clinical settings.
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Panel Discussion
Pannet PangputhipongThailand
Speaker
Phacoemulsification: Challenging and Interesting CasesPhacoemulsification in complex cases is always challenging. Situations such as hard nucleus, intumescent cataract, posterior polar cataract, loose zonule, or small pupil require special surgical techniques to overcome the difficulties. In some patients, multiple complexities may occur simultaneously, making the procedure extremely challenging—sometimes described as a surgeon’s nightmare.
This presentation will highlight selected interesting cases and demonstrate strategies to manage them safely, guiding surgeons on how to navigate through these “war zone” scenarios with confidence.Challenges in Soft Nucleus: Don’t Drown in Shallow WaterPhacoemulsification in soft nuclei can be challenging if inappropriate techniques are used. The soft nature of the nucleus makes nuclear disassembly difficult. Chopping and rotation are not easily performed because the chopper tends to cut through the nuclear mass when cracking or rotational force is applied, without achieving satisfactory results. The phaco tip also cannot hold the nucleus firmly enough during chopping or pulling.
“Stab Test” using a 27g. hydrodissection canular to determine the hardness of the nucleus before performing hydrodissection is essential, in order to choose the most appropriate phaco technique.
Special techniques such as Hydro Subluxation + Aspiration, Hydro Subluxation + Flip & Chop, Half Bowl + Rim Aspiration, and Chip & Flip (I. Howard Fine) will be discussed, including phacodynamics for soft nuclei.
When proper techniques are applied, surgery can be performed safely and effectively.
Matteo PiovellaItaly
Speaker
Refractive cataract surgery to correct and eliminate presbyopia to achieve better vision in patients undergoing cataract surgerySynopsis Refractive cataract surgery is now replacing standard high-volume, low-cost cataract
surgery with monofocal IOL implantation. The possibility is to correct refractive defects, myopia,
hyperopia and astigmatism and overcome presbyopia limitations. It is necessary to change the
preoperative patient procedures and manage Meibomian gland dysfunction in cataract patients.
Normally three treatments should be applied: BlephEx (Alcon) to eliminate Demodex blepharitis
Biofilm and to open glands duct LipiFlow (J&J) to get postoperative refractive emmetropia. In this
course, we will review state-of-the-art knowledge on refractive cataract surgery in pursuing highly
satisfactory uncorrected distance, intermediate and near vision. Routine dry eye management will
be discussed. Advanced biometry, multiple shots and new procedures will be explained and
demonstrated .The new technical model for the adoption of refractive cataract surgery: biometry evaporative dry eye pupil-dependent trifocal IOLsSynopsis PRESENTATION will certify as postoperative precise IOL power detection is based on quality of
tear film to provide cornea smooth surface.Improvements . Multiple biometry exams are needed
until refractive IOLs power stabilization
Objective The MAPRY/clear oil protocol is based on consecutive session with three phisical
treatments. First treatment applied is Blephex(LLC) to remove Demodex, Biofilm and to unclog
excretory channels of the meibomian glands Second Treatment,LipiFlow (J&J),replaces occlusions
of the MG warming the material responsible of MGD improving a solid sttatification into the liquid
state easier to remove. ILux (Alcon)expels deeply from the meibomian glands the substances
responsible for their obstruction. The MAPRY protocol is based on one session per month at least
for 5 months, depending the grade and penetration ofhronic eyelids inflammation
FAM Han BorSingapore
Speaker
Astigmatism with TK more Accurate for Toric Calculation?This presentation explores the impact of Total Keratometry (TK) on the calculation of toric intraocular lenses (IOLs), focusing on the role of posterior corneal astigmatism (PCA) in refractive outcomes. Drawing on large datasets and recent studies, it highlights that PCA is a significant factor in toric IOL planning, with traditional keratometry often leading to over-correction of with-the-rule (WTR) and under-correction of against-the-rule (ATR) astigmatism. The presentation reviews evidence showing that using measured PCA values, rather than predicted ones, improves the accuracy of postoperative astigmatism prediction, especially when the steep axis of PCA is non-vertical. Comparative analysis of various toric IOL formulas demonstrates that EVO formulas with measured PCA yield the smallest centroid errors and highest percentage of eyes within 0.50D of predicted astigmatism, particularly in cases with non-vertical PCA. The findings underscore the importance of incorporating TK and measured PCA into toric IOL calculations to optimise refractive outcomes for cataract patients.
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Filomena RIBEIROPortugal
Moderator
Neuroadaptation in Premium IOL PatientsNeuroadaptation is a key determinant of visual success and satisfaction after implantation of premium intraocular lenses. This session will discuss how the brain adapts to new optical conditions created by simultaneous vision IOLs, integrating multiple focal points while minimising photic phenomena. Clinical data and patient-reported outcomes will illustrate the variability and time course of adaptation, highlighting the influence of IOL design and individual neural plasticity. Understanding and supporting neuroadaptation are essential to optimise outcomes and enhance patient experience with modern premium IOL technologies.ESCRS Multiformulas IOL Power Calculator AccuracyAccurate intraocular lens (IOL) power calculation remains a critical determinant of refractive outcomes following cataract surgery. The ESCRS IOL Calculator integrates modern formulas to improve prediction accuracy and support IOL selection across diverse biometric profiles. This lecture will review recent data assessing the performance of the ESCRS Calculator in comparison with individual formulas, focusing on its refractive predictability, consistency across axial lengths, and clinical usability.
Results from validation studies and real-world datasets will be presented, highlighting the calculator’s strengths and limitations, as well as its role in optimising outcomes in standard and challenging eyes. The session will also address practical considerations for integration into clinical workflow and the ongoing evolution of formula combinations as biometry and lens technology continue to advance.
Burkhard DickGermany
Moderator
ESCRS Cataract Guidelines RecommendationsThe ESCRS Cataract Guidelines represent a comprehensive and evidence-based framework designed to support cataract surgeons across Europe in delivering safe, effective, and consistent care. In this presentation, an overview of the most relevant recommendations will be provided as well as key updates based on the latest clinical evidence.
Drawing from robust literature reviews and expert consensus, the ESCRS Guidelines cover the full patient journey: from preoperative assessment and biometry, to surgical technique, IOL selection, intraoperative considerations, and postoperative care. Emphasis will be placed on areas of evolving practice (SV IOL and infection prophylaxis).
Background will be given on how the guideline development process was designed to ensure practical relevance while maintaining scientific rigor, and how implementation can be supported across diverse healthcare settings. The goal is not only to standardize best practices but also to allow flexibility where justified by patient needs or surgical complexity.
This talk aims to provide attendees with clear, actionable insights from the ESCRS Cataract Guidelines that can enhance surgical outcomes and support continuous quality improvement in cataract care.IOL Exchange in the Premium IOL Era: Challenges and SolutionsThe rise of simultaneous vision intraocular lenses (SV IOLs), including multifocal, extended depth of focus, and toric designs, has significantly expanded visual outcomes in cataract and refractive surgery. However, this progress has been accompanied by an increase in the complexity and frequency of postoperative patient dissatisfaction, leading to a higher demand for IOL exchange in select cases.
This presentation explores the unique challenges of IOL exchange in the era of SV IOL technologies. Key indications for explantation will be reviewed, including suboptimal visual quality, dysphotopsia, residual ametropia, and rotational instability. Emphasis will be placed on clinical decision-making, diagnostic precision, and the timing of intervention, particularly in light of evolving patient expectations. Surgical strategies for safe and effective explantation will be discussed.
In addition, the importance of careful patient selection, preoperative counseling, and enhanced biometric planning as critical factors in reducing the need for IOL exchange will be highlighted. Emerging technologies that may support more accurate IOL selection and customization will also be briefly introduced.
This talk aims to provide practical guidance for surgeons facing the growing demands of managing SV IOL complications and achieving optimal outcomes through safe exchange procedures.
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Filomena RIBEIROPortugal
Speaker
Neuroadaptation in Premium IOL PatientsNeuroadaptation is a key determinant of visual success and satisfaction after implantation of premium intraocular lenses. This session will discuss how the brain adapts to new optical conditions created by simultaneous vision IOLs, integrating multiple focal points while minimising photic phenomena. Clinical data and patient-reported outcomes will illustrate the variability and time course of adaptation, highlighting the influence of IOL design and individual neural plasticity. Understanding and supporting neuroadaptation are essential to optimise outcomes and enhance patient experience with modern premium IOL technologies.ESCRS Multiformulas IOL Power Calculator AccuracyAccurate intraocular lens (IOL) power calculation remains a critical determinant of refractive outcomes following cataract surgery. The ESCRS IOL Calculator integrates modern formulas to improve prediction accuracy and support IOL selection across diverse biometric profiles. This lecture will review recent data assessing the performance of the ESCRS Calculator in comparison with individual formulas, focusing on its refractive predictability, consistency across axial lengths, and clinical usability.
Results from validation studies and real-world datasets will be presented, highlighting the calculator’s strengths and limitations, as well as its role in optimising outcomes in standard and challenging eyes. The session will also address practical considerations for integration into clinical workflow and the ongoing evolution of formula combinations as biometry and lens technology continue to advance.
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Burkhard DickGermany
Speaker
ESCRS Cataract Guidelines RecommendationsThe ESCRS Cataract Guidelines represent a comprehensive and evidence-based framework designed to support cataract surgeons across Europe in delivering safe, effective, and consistent care. In this presentation, an overview of the most relevant recommendations will be provided as well as key updates based on the latest clinical evidence.
Drawing from robust literature reviews and expert consensus, the ESCRS Guidelines cover the full patient journey: from preoperative assessment and biometry, to surgical technique, IOL selection, intraoperative considerations, and postoperative care. Emphasis will be placed on areas of evolving practice (SV IOL and infection prophylaxis).
Background will be given on how the guideline development process was designed to ensure practical relevance while maintaining scientific rigor, and how implementation can be supported across diverse healthcare settings. The goal is not only to standardize best practices but also to allow flexibility where justified by patient needs or surgical complexity.
This talk aims to provide attendees with clear, actionable insights from the ESCRS Cataract Guidelines that can enhance surgical outcomes and support continuous quality improvement in cataract care.IOL Exchange in the Premium IOL Era: Challenges and SolutionsThe rise of simultaneous vision intraocular lenses (SV IOLs), including multifocal, extended depth of focus, and toric designs, has significantly expanded visual outcomes in cataract and refractive surgery. However, this progress has been accompanied by an increase in the complexity and frequency of postoperative patient dissatisfaction, leading to a higher demand for IOL exchange in select cases.
This presentation explores the unique challenges of IOL exchange in the era of SV IOL technologies. Key indications for explantation will be reviewed, including suboptimal visual quality, dysphotopsia, residual ametropia, and rotational instability. Emphasis will be placed on clinical decision-making, diagnostic precision, and the timing of intervention, particularly in light of evolving patient expectations. Surgical strategies for safe and effective explantation will be discussed.
In addition, the importance of careful patient selection, preoperative counseling, and enhanced biometric planning as critical factors in reducing the need for IOL exchange will be highlighted. Emerging technologies that may support more accurate IOL selection and customization will also be briefly introduced.
This talk aims to provide practical guidance for surgeons facing the growing demands of managing SV IOL complications and achieving optimal outcomes through safe exchange procedures.
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王元聖 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.
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Moderator
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Joaquín FERNÁNDEZSpain
Speaker
Simultaneous Vision IOLs ESCRS ClassificationThe rapid expansion of intraocular lens (IOL) designs and the increasing volume of clinical research supporting their functional outcomes have underscored the need for a unified and globally standardized Functional Vision Framework. The European, American, Asia-Pacific, and Latin American Societies of Cataract and Refractive Surgeons have collaboratively established the Global Functional Vision Working Group (FVWG) to harmonize terminology, methodologies, and outcome reporting in IOL evaluation. This initiative introduces a Functional Classification based on the depth of field (DOFi) and visual acuity enhancement across intermediate to near distances, organized into six progressive categories reflecting different visual performance profiles. Unlike regulatory classifications, such as ISO 11979-7:2024, which focus on safety and pre-market efficacy, the FVWG Functional Classification aims to provide post-market, clinically meaningful differentiation that aligns with patient-centered care and real-world functional benefits. The framework also advocates the integration of additional endpoints, including contrast sensitivity, biometric influences, and validated patient-reported outcome measures such as the AIOLIS questionnaire. Future directions emphasize the development of guidelines to assess the certainty of functional performance based on a hierarchy of evidence, from optical bench predictions to clinical validation and meta-analyses. By aligning technical and patient-oriented perspectives, the FVWG’s Functional Vision Framework represents a major advancement toward global standardization in IOL research and clinical practice. It provides clinicians, researchers, and industry with a robust foundation for consistent measurement, transparent communication, and improved shared decision-making in the selection and evaluation of IOL technologies.
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賴俊杰 Chun-Chieh LaiTaiwan
Speaker
Trends and Market Share of Presbyopia-Correcting Intraocular Lenses in Taiwan & Asia In this section, we will talk about the trends and market share of presbyopia-correcting intraocular lenses in Taiwan and Asia.Minimize Further Dehiscence of Zonules in Patients with Large Zonular Weakness Zonular weakness increases the likelihood of dealing with complicated cataract surgery and encountering postoperative complications. These risks include intra- and postoperative complications from cataract surgery, such as posterior capsular rupture, vitreous loss, and lens dislocation and decentration.
Common risk factors for weak zonules are pseudoexfoliation syndrome, mature cataracts, high myopia, Marfan syndrome, and prior ocular surgery. Signs of weak zonules include iridodonesis, phacodonesis, abnormal anterior chamber depth or asymmetry, angle asymmetry on gonioscopy, and vitreous in the anterior chamber. Zonular dehiscence and lens subluxation or dislocation can be seen in advanced zonulopathy. But most of the time, weak zonules may not be noticed until after the surgery has begun. Intraoperative signs of weak zonules include anterior chamber depth fluctuation, difficulty puncturing the anterior lens capsule, star-shaped striae on the capsule surface during the capsulorhexis, lens movement when manipulations, and difficulty in rotating the nucleus within the capsular bag despite adequate hydrodissection.
In this video discussion, we will talk about how to minimize further dehiscence of zonules in patients with large zonular weakness during operation and make the cataract surgery safer.
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Moderator
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Pavel STODULKA
Speaker
ESCRS Refractive Surgery GuidelinesThe ESCRS refractive surgery guidelines are evidence-based and provide fundamental classifications of ametropia, target refraction, and available refractive surgical procedures. For each procedure, the guidelines outline its variants, indications, advantages, and limitations. They also define safety thresholds and technical limits applicable to refractive surgery.
The guidelines describe the key components of the refractive surgery patient journey: (1) screening and patient selection, (2) diagnostic and preoperative evaluation, (3) procedure selection, (4) perioperative management, and (5) postoperative follow-up. Patient education and expectation management, including informed consent, are comprehensively addressed. Systemic and ocular contraindications, as well as dry eye disease and Meibomian gland dysfunction, are also discussed.
Common complications and side effects are listed, including both corneal and lens-related issues. The importance of surgeon experience is emphasized.
In summary, the refractive surgery guidelines serve as a clinical tool rather than a legal standard. They promote high-quality, well-informed patient care. Future updates will follow emerging evidence, with patient-reported outcome measures (PROMs) and personalized approaches representing key directions for development.
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侯鈞賀 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.
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Moderator
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Filomena RIBEIROPortugal
Speaker
Neuroadaptation in Premium IOL PatientsNeuroadaptation is a key determinant of visual success and satisfaction after implantation of premium intraocular lenses. This session will discuss how the brain adapts to new optical conditions created by simultaneous vision IOLs, integrating multiple focal points while minimising photic phenomena. Clinical data and patient-reported outcomes will illustrate the variability and time course of adaptation, highlighting the influence of IOL design and individual neural plasticity. Understanding and supporting neuroadaptation are essential to optimise outcomes and enhance patient experience with modern premium IOL technologies.ESCRS Multiformulas IOL Power Calculator AccuracyAccurate intraocular lens (IOL) power calculation remains a critical determinant of refractive outcomes following cataract surgery. The ESCRS IOL Calculator integrates modern formulas to improve prediction accuracy and support IOL selection across diverse biometric profiles. This lecture will review recent data assessing the performance of the ESCRS Calculator in comparison with individual formulas, focusing on its refractive predictability, consistency across axial lengths, and clinical usability.
Results from validation studies and real-world datasets will be presented, highlighting the calculator’s strengths and limitations, as well as its role in optimising outcomes in standard and challenging eyes. The session will also address practical considerations for integration into clinical workflow and the ongoing evolution of formula combinations as biometry and lens technology continue to advance.
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Moderator
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Filomena RIBEIROPortugal
Speaker
Neuroadaptation in Premium IOL PatientsNeuroadaptation is a key determinant of visual success and satisfaction after implantation of premium intraocular lenses. This session will discuss how the brain adapts to new optical conditions created by simultaneous vision IOLs, integrating multiple focal points while minimising photic phenomena. Clinical data and patient-reported outcomes will illustrate the variability and time course of adaptation, highlighting the influence of IOL design and individual neural plasticity. Understanding and supporting neuroadaptation are essential to optimise outcomes and enhance patient experience with modern premium IOL technologies.ESCRS Multiformulas IOL Power Calculator AccuracyAccurate intraocular lens (IOL) power calculation remains a critical determinant of refractive outcomes following cataract surgery. The ESCRS IOL Calculator integrates modern formulas to improve prediction accuracy and support IOL selection across diverse biometric profiles. This lecture will review recent data assessing the performance of the ESCRS Calculator in comparison with individual formulas, focusing on its refractive predictability, consistency across axial lengths, and clinical usability.
Results from validation studies and real-world datasets will be presented, highlighting the calculator’s strengths and limitations, as well as its role in optimising outcomes in standard and challenging eyes. The session will also address practical considerations for integration into clinical workflow and the ongoing evolution of formula combinations as biometry and lens technology continue to advance.
Burkhard DickGermany
Speaker
ESCRS Cataract Guidelines RecommendationsThe ESCRS Cataract Guidelines represent a comprehensive and evidence-based framework designed to support cataract surgeons across Europe in delivering safe, effective, and consistent care. In this presentation, an overview of the most relevant recommendations will be provided as well as key updates based on the latest clinical evidence.
Drawing from robust literature reviews and expert consensus, the ESCRS Guidelines cover the full patient journey: from preoperative assessment and biometry, to surgical technique, IOL selection, intraoperative considerations, and postoperative care. Emphasis will be placed on areas of evolving practice (SV IOL and infection prophylaxis).
Background will be given on how the guideline development process was designed to ensure practical relevance while maintaining scientific rigor, and how implementation can be supported across diverse healthcare settings. The goal is not only to standardize best practices but also to allow flexibility where justified by patient needs or surgical complexity.
This talk aims to provide attendees with clear, actionable insights from the ESCRS Cataract Guidelines that can enhance surgical outcomes and support continuous quality improvement in cataract care.IOL Exchange in the Premium IOL Era: Challenges and SolutionsThe rise of simultaneous vision intraocular lenses (SV IOLs), including multifocal, extended depth of focus, and toric designs, has significantly expanded visual outcomes in cataract and refractive surgery. However, this progress has been accompanied by an increase in the complexity and frequency of postoperative patient dissatisfaction, leading to a higher demand for IOL exchange in select cases.
This presentation explores the unique challenges of IOL exchange in the era of SV IOL technologies. Key indications for explantation will be reviewed, including suboptimal visual quality, dysphotopsia, residual ametropia, and rotational instability. Emphasis will be placed on clinical decision-making, diagnostic precision, and the timing of intervention, particularly in light of evolving patient expectations. Surgical strategies for safe and effective explantation will be discussed.
In addition, the importance of careful patient selection, preoperative counseling, and enhanced biometric planning as critical factors in reducing the need for IOL exchange will be highlighted. Emerging technologies that may support more accurate IOL selection and customization will also be briefly introduced.
This talk aims to provide practical guidance for surgeons facing the growing demands of managing SV IOL complications and achieving optimal outcomes through safe exchange procedures.
-
Burkhard DickGermany
Speaker
ESCRS Cataract Guidelines RecommendationsThe ESCRS Cataract Guidelines represent a comprehensive and evidence-based framework designed to support cataract surgeons across Europe in delivering safe, effective, and consistent care. In this presentation, an overview of the most relevant recommendations will be provided as well as key updates based on the latest clinical evidence.
Drawing from robust literature reviews and expert consensus, the ESCRS Guidelines cover the full patient journey: from preoperative assessment and biometry, to surgical technique, IOL selection, intraoperative considerations, and postoperative care. Emphasis will be placed on areas of evolving practice (SV IOL and infection prophylaxis).
Background will be given on how the guideline development process was designed to ensure practical relevance while maintaining scientific rigor, and how implementation can be supported across diverse healthcare settings. The goal is not only to standardize best practices but also to allow flexibility where justified by patient needs or surgical complexity.
This talk aims to provide attendees with clear, actionable insights from the ESCRS Cataract Guidelines that can enhance surgical outcomes and support continuous quality improvement in cataract care.IOL Exchange in the Premium IOL Era: Challenges and SolutionsThe rise of simultaneous vision intraocular lenses (SV IOLs), including multifocal, extended depth of focus, and toric designs, has significantly expanded visual outcomes in cataract and refractive surgery. However, this progress has been accompanied by an increase in the complexity and frequency of postoperative patient dissatisfaction, leading to a higher demand for IOL exchange in select cases.
This presentation explores the unique challenges of IOL exchange in the era of SV IOL technologies. Key indications for explantation will be reviewed, including suboptimal visual quality, dysphotopsia, residual ametropia, and rotational instability. Emphasis will be placed on clinical decision-making, diagnostic precision, and the timing of intervention, particularly in light of evolving patient expectations. Surgical strategies for safe and effective explantation will be discussed.
In addition, the importance of careful patient selection, preoperative counseling, and enhanced biometric planning as critical factors in reducing the need for IOL exchange will be highlighted. Emerging technologies that may support more accurate IOL selection and customization will also be briefly introduced.
This talk aims to provide practical guidance for surgeons facing the growing demands of managing SV IOL complications and achieving optimal outcomes through safe exchange procedures.
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EN
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林慧茹 Hui-Ju LinTaiwan
Speaker
Advances in Artificial Intelligence Models and Algorithms in Amblyopia and Strabismus Review of Artificial Intelligence (AI) models that detect strabismus and amblyopia risk factors from smartphone photos, videos, and images, facilitating large-scale, accessible community screening. Discussion on how AI is personalizing amblyopia therapy, thereby maximizing efficacy and engagement. Critical appraisal of the requirements for clinical validation, regulatory approval, and the ethical integration of these AI tools into standard ophthalmic practice.
AI is poised to fundamentally reshape the management of strabismus and amblyopia by introducing unprecedented levels of objectivity, accessibility, and personalization. the knowledge to understand, evaluate, and eventually integrate these powerful technologies into their practice to improve patient outcomes. AI screening and diagnosis to treatment optimization and monitoring.
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林慧茹 Hui-Ju LinTaiwan
Moderator
Advances in Artificial Intelligence Models and Algorithms in Amblyopia and Strabismus Review of Artificial Intelligence (AI) models that detect strabismus and amblyopia risk factors from smartphone photos, videos, and images, facilitating large-scale, accessible community screening. Discussion on how AI is personalizing amblyopia therapy, thereby maximizing efficacy and engagement. Critical appraisal of the requirements for clinical validation, regulatory approval, and the ethical integration of these AI tools into standard ophthalmic practice.
AI is poised to fundamentally reshape the management of strabismus and amblyopia by introducing unprecedented levels of objectivity, accessibility, and personalization. the knowledge to understand, evaluate, and eventually integrate these powerful technologies into their practice to improve patient outcomes. AI screening and diagnosis to treatment optimization and monitoring.
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陳南妮 Nan-Ni ChenTaiwan
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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Hyun Jin ShinKorea (Republic of)
Speaker
Emergence Point of the Infratrochlear Nerve With Reference to the Nasion and Its Clinical Implications in Craniofacial SurgeryAbstract
Infratrochlear nerve (ITN) block is widely utilized for achieving surgical anesthesia, reducing postoperative pain, and treating neuralgia. The aim of this study was to identify the emerging point of the ITN (EP-ITN) in the medial orbital margin with reference to the nasion in order to enhance the effectiveness of regional ITN block in craniofacial surgery. Thirty-eight hemifaces from 19 embalmed Korean cadavers were dissected. Measurements were made of the vertical distances from the EP-ITN to key landmarks such as the nasion, the inferior border of the trochlea, and the medial canthus. The study also analyzed facial morphology by measuring the horizontal and vertical dimensions of the midface and orbit. The spatial relationships between these landmarks and the EP-ITN relative to the dimensions of the midface and orbit were also evaluated. The distances from the EP-ITN to the nasion, trochlea, and medial canthus were 1.6±1.3 mm (mean±standard deviation), 19.7±1.7 mm, and 11.7±2.0 mm, respectively. The distance between the trochlea and the EP-ITN also tended to increase as the horizontal dimensions of the midface and orbit increased. However, the dimensions of the midface and orbit did not significantly affect the distance from the nasion to the EP-ITN. In conclusion, the nasion is located nearer to the EP-ITN than to other landmarks and maintains a consistent spatial relationship that is unaffected by variations in the size of the midface or orbit. This means that it can serve as a reliable external landmark for guiding the ITN block technique.
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Sun Woong KimKorea (Republic of)
Speaker
Mouse Meibomian Gland Progenitor Cell Organoids as an In Vitro Model of Acinar and Ductal DifferentiationPurpose: Recent studies have shown that two-dimensional (2D) culture of primary rabbit and immortalized human meibomian gland epithelial cells (iHMGEC) do not recapitulate normal meibocyte differentiation, but 3D-spheroid culture of iHMGEC can facilitate meibocyte differentiation. The purpose of this study was to develop mouse meibomian gland (MG) organoid which can be capable of differentiating to MG acini and duct.
Methods: Mouse meibomian gland epithelial cells were isolated and were suspended in matrigel/basement membrane matrix and grown in proliferation media supplemented with Rock inhibitor (Y-27632), Noggin, A8301, FGF10, and Rspondin1 to form adult progenitor cell clusters or spheroids. Cells were then differentiated with serum-free, differentiation media with or without synthetic agonists for the nuclear lipid receptor, peroxisome proliferator activator receptor gamma (PPARγ). Cells were then evaluated for differentiation markers using western blotting, immunocytochemistry (ICC) and real-time PCR.
Results: The 3D culture induced the formation of KRT5+ spheroids that were enriched with Lrig1+, Sox9+, and Lgr6+ cells at the outer layer. These MG progenitor cell organoids can be passaged more than 30 times and were still capable of developing MG-like phenotypes as indicated by lipid synthesis as well as expression of essential proteins related to meibum synthesis. When MG progenitor cell organoids were switched to differentiation media containing PPARγ agonists, accumulation of lipid droplets and cell death were observed in the center of organoids, which demonstrates that these progenitor cell organoids can differentiate and response to differentiation signals. Meibocyte differentiation marker, AWAT2+/PPARγ+ were expressed in acini-like organoid and KRT6a+ duct like organoids were also formed. Some organoids showed both duct and acini phenotypes.
Conclusions: The 3D culturing of mouse MG progenitor cells can induce the formation of both acini and ductal organoids and may thus serve as a better in vitro model system for studying the regulatory mechanisms controlling meibomian gland function. Mimicking MG homeostasis, the outer layer of MG organoids is composed of proliferating cells that migrate inward, undergo terminal differentiation and generating lipid-filled meibocytes.
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王安國 An-Guor WangTaiwan
Moderator
Upshooting Eye After TED IR Myectomy: How Do We Manage? Two TED patients received IR myectomy for hypotropoia. They developed upshooting eyes with severe limitation of infraduction postoperatively. We collaborated with ENT surgeon using endoscopic surgery with navigation system to identify the proximal stump of IR, and repair with non-absorbable suture. Both patients recovered their binocular vision after the operation.
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Min Chae KangKorea (Republic of)
Speaker
Monitoring Changes in Optic Nerve Thickness Using OCT in Patients with Pseudopapilledema Associated with Peripapillary Hyperreflective Ovoid Mass-like Structures (PHOMS)This study investigated longitudinal changes in optic nerve thickness using spectral-domain optical coherence tomography (SD-OCT) in patients with pseudopapilledema associated with peripapillary hyperreflective ovoid mass-like structures (PHOMS). Ninety-two eyes from 48 patients were evaluated, and peripapillary retinal nerve fiber layer (pRNFL) thickness was measured in five sectors (average, superior, inferior, temporal, and nasal) for up to 24 months. Eyes were classified as either “with increase in pRNFL thickness” or “without increase,” based on an average pRNFL increase of ≥5 μm compared with the previous measurement and a monthly rate of ≥10 μm. Sixty-four eyes showed no increase, while 28 demonstrated thickening. Age, sex, refractive error, and time to maximal thickening did not differ significantly between groups. The group with thickness increase had greater average (116.95 ± 29.41 vs. 106.87 ± 19.02, p = 0.034) and inferior (161.18 ± 60.12 vs. 136.63 ± 28.01, p = 0.034) sectoral values. Changes from the previous measurement were larger in this group for the average (0.81 ± 16.02 vs. −3.43 ± 12.50, p = 0.029) and inferior (4.73 ± 35.08 vs. −5.10 ± 16.11, p = 0.013) sectors, with the inferior sector showing the greatest change (p = 0.037). The monthly rate of change was also higher across several sectors in eyes with increased thickness. These results suggest that PHOMS-related pseudopapilledema demonstrates dynamic optic nerve morphology, and that inferior sector pRNFL fluctuations on OCT may serve as a useful indicator of optic nerve changes in these patients.
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Yun Jeong LeeSouth Korea
Speaker
Deep Learning for Differentiating Glaucomatous and Non-glaucomatous Optic Neuropathy with Retinal Nerve Fiber Layer and Optic Disc PhotographsPurpose: To develop a deep learning (DL)-based algorithm to differentiate glaucomatous optic neuropathy (GON) and non-glaucomatous optic neuropathy (NGON) with retinal nerve fiber layer (RNFL) and optic disc photographs.
Methods: A total of 765 image pairs (618 GON, 147 NGON) were retrospectively collected and preprocessed using histogram matching and region-of-interest cropping based on Hough circle detection. An external validation dataset consisting of 177 pairs (103 GON, 74 NGON) was also used. DL models were developed using ResNet34 for optic disc images and DenseNet121 for RNFL images, with feature-level fusion implemented via cross-attention mechanisms. Model training involved data augmentation, class imbalance correction, and five-fold cross-validation. Model interpretability was assessed using Grad-CAM visualization.
Results: The proposed model demonstrated robust performance in both internal and external datasets. In the internal validation set, the DL model achieved an AUC of 0.98 with the RNFL images, which was comparable to that with the optic disc (AUC of 0.99, P = 0.23) or combined RNFL and optic disc images (AUC of 0.98, P = 0.70), and was significantly superior to that with the masked RNFL (AUC of 0.94, P < 0.05) or combined masked RNFL and optic disc images (AUC of 0.96, P < 0.05). In the external validation set, the fusion model integrating both RNFL and optic disc images achieved superior diagnostic performance compared to single-modality models, with the highest AUC (0.88).
Conclusions: The proposed multi-input DL model effectively differentiates between GON and NGON using RNFL and optic disc photographs. By integrating structural features via cross-attention, the model achieves consistent diagnostic performance, even in external datasets. This suggests the potential value of our DL model in clinical practice by helping clinicians make accurate diagnoses and treatment decisions.
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陳達慶 Ta-Ching ChenTaiwan
Moderator
Hidden Variants in Inherited Retinal Degeneration and Their Impact on Gene-Targeted TreatmentIn this short talk, we would like to share the experience about systematically identifying pathogenic splicing variants and characterizing their transcript-level consequences to enhance the the molecular diagnosis of inherited retinal degeneration (IRD). In 738 IRD families, a splicing variant detection pipeline, integrating two computational algorithms (SpliceAI and dbscSNV_ADA) with functional validation via minigene assays, was implemented to detect splice-disrupting variants beyond canonical sites. Splicing variants accounted for 14% of genetically diagnosed families. Of these, 4% were newly identified through our combined computational and experimental platform. Notably, 28% of all splice-disrupting variants, located in noncanonical, exonic, or deep-intronic regions, would likely have been missed by conventional analysis pipelines, which typically prioritize protein-coding changes and canonical splice sites, and often lack systematic evaluation of splicing effects beyond these regions. Five recurrent splice-disrupting variants were observed across multiple families, including EYS:c.5644+5G>A, which caused exon truncation and was found in 11 unrelated families. Functional assays confirmed aberrant splicing, and the associated phenotypes were consistent with known disease presentations. This study demonstrates the utility of a combined splicing variant detection platform in uncovering hidden pathogenic variants and improving IRD diagnostic yield. These findings have implications for refining genetic testing and guiding the development of splicing-targeted therapies.
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Sung who ParkKorea (Republic of)
Speaker
Pseudophakic Cystoid Macular Edema (PCME): The Central Role of Lens Removal and Anterior Uveal RemodelingBackground: PCME, commonly manifesting 4 to 12 weeks following cataract surgery, is characterized by increased vascular permeability. While its high responsiveness to topical NSAIDs suggests prostaglandin involvement, key paradoxes remain: Why is PCME frequently induced by the relatively simple cataract procedure, yet rarely follows more invasive surgeries like vitrectomy or trabeculectomy? And how do topical NSAIDs achieve therapeutic efficacy at the macula despite anatomical barriers such as the cornea and continuous aqueous flow?
Hypothesis and Methods: We hypothesize that the pathological trigger is not generalized surgical trauma, but the structural changes caused by crystalline lens removal. The replacement of the large, heavy crystal lens with a small, lightweight intraocular lens necessitates adaptive remodeling of the anterior uvea. We propose that this remodeling results in prostaglandin release from this key pathological structure. To verify this, we conducted two studies analyzing PCME incidence after vitrectomy alone versus phacovitrectomy.
Results: Our findings demonstrated that PCME incidence is significantly higher following phacovitrectomy compared to vitrectomy alone, strongly implicating lens removal as the main trigger for the syndrome. Furthermore, PCME was effectively reduced by topical NSAID administration after phacovitrectomy but was not significantly affected by the same treatment following vitrectomy alone.
Conclusion: PCME pathogenesis is redefined by circumstances changes induced by crystalline lens removal, leading to prostaglandin release mediated by the anterior uvea. This novel model challenges the traditional view that PCME is solely a consequence of non-specific surgical inflammation, offering a precise anatomical target for both research and prophylaxis.
701F
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14:30
17:30
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EN
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姚克 Yao KeChina
Speaker
Adances in FLACS Cataract surgery in China has experienced a profound transformation, evolving from traditional practices
to the implementation of advanced techniques like Femtosecond Laser-Assisted Cataract Surgery
(FLACS). This lecture provides an overview of the recent clinical research in Mainland China, focusing on
optimizing surgical workflows, refining patient selection criteria, and evaluating visual and refractive
outcomes associated with FLACS. Data from these studies have contributed to evidence-based protocols
that support the safe and effective implementation of laser-assisted cataract procedures across diverse
clinical settings.
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Matteo PiovellaItaly
Speaker
Refractive cataract surgery to correct and eliminate presbyopia to achieve better vision in patients undergoing cataract surgerySynopsis Refractive cataract surgery is now replacing standard high-volume, low-cost cataract
surgery with monofocal IOL implantation. The possibility is to correct refractive defects, myopia,
hyperopia and astigmatism and overcome presbyopia limitations. It is necessary to change the
preoperative patient procedures and manage Meibomian gland dysfunction in cataract patients.
Normally three treatments should be applied: BlephEx (Alcon) to eliminate Demodex blepharitis
Biofilm and to open glands duct LipiFlow (J&J) to get postoperative refractive emmetropia. In this
course, we will review state-of-the-art knowledge on refractive cataract surgery in pursuing highly
satisfactory uncorrected distance, intermediate and near vision. Routine dry eye management will
be discussed. Advanced biometry, multiple shots and new procedures will be explained and
demonstrated .The new technical model for the adoption of refractive cataract surgery: biometry evaporative dry eye pupil-dependent trifocal IOLsSynopsis PRESENTATION will certify as postoperative precise IOL power detection is based on quality of
tear film to provide cornea smooth surface.Improvements . Multiple biometry exams are needed
until refractive IOLs power stabilization
Objective The MAPRY/clear oil protocol is based on consecutive session with three phisical
treatments. First treatment applied is Blephex(LLC) to remove Demodex, Biofilm and to unclog
excretory channels of the meibomian glands Second Treatment,LipiFlow (J&J),replaces occlusions
of the MG warming the material responsible of MGD improving a solid sttatification into the liquid
state easier to remove. ILux (Alcon)expels deeply from the meibomian glands the substances
responsible for their obstruction. The MAPRY protocol is based on one session per month at least
for 5 months, depending the grade and penetration ofhronic eyelids inflammation
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Chan Yun KIMKorea (Republic of)
Speaker
Minimally Invasive Bleb Surgery (MIBS): Redefining Safety and Efficacy in Glaucoma SurgeryMinimally Invasive Bleb Surgery (MIBS) represents a significant advancement in glaucoma treatment, combining the efficacy of traditional filtering procedures with the safety and simplicity of minimally invasive techniques. Devices such as the XEN Gel Stent, PreserFlo MicroShunt, and A-stream enable subconjunctival outflow with less tissue disruption.
This talk will review the core principles of MIBS, compare it with conventional surgery and MIGS, and highlight recent clinical outcomes. MIBS offers a promising surgical option for patients requiring effective intraocular pressure control with a lower risk profile.Advances in Contemporary Glaucoma Surgery: Innovations and Clinical ImpactThe field of glaucoma surgery has undergone remarkable transformation in recent years, driven by innovations aimed at improving efficacy, safety, and patient outcomes. This presentation will explore key advancements in surgical techniques, including the evolution of MIGS (Minimally Invasive Glaucoma Surgery), the emergence of MIBS (Minimally Invasive Bleb Surgery), and improvements in conventional filtering procedures.
Emphasis will be placed on how these innovations have influenced clinical decision-making, expanded surgical options across disease severity, and reshaped postoperative management. By examining current evidence and real-world outcomes, this talk aims to provide a comprehensive overview of the modern surgical landscape in glaucoma care and its practical implications for clinicians.
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孫興懷 Xinghuai SunChina
Speaker
Sustained drug-release glaucoma systems will replace eye drops"Glaucoma is a lifelong chronic disease, the only proven effective way to control glaucoma is lowering IOP, that’s an important pathological factor. In clinical, surgeries have effective, but not perfect. Eye drops still the keystone of anti-glaucoma treatment. But there are some limitations of anti-glaucoma drops with poor therapeutic benefits, like low aqueous humor bioavailability less 5%, lack of patient compliance, long-term IOP fluctuations with glaucoma progression, and with cumulative drug toxicity or adverse effects caused by drops active pharmaceutical ingredients and additives. So there are need improving therapeutic benefits following the ways like new dosage form/formulation, less relying on patient effort, sustained drug delivery all time and drug delivery with low dose. Sustained release glaucoma systems do much better than eye drops in delivering medications, so the greater therapeutic benefits and the better patient compliance could obtained. There are more and more clinical trials about sustained release systems for glaucoma. We introduced our some research results about lowering IOP sustained systems.
Sustained release system is a general development trend for glaucoma therapy, but most influenced by other two leading factors: out-of-pocket cost and interval between administrations. I think sustained release glaucoma systems will replace eye drops in the future."
Clinical Evaluation of Retinal Blood Flow in Glaucoma by OCTAFollowing the morphological structure of OCT, OCTA has contribute to the in-depth study of the mechanism of nerve damage and treatment evaluation in glaucoma. We have carried out clinical study of OCTA in glaucoma to quantify the peripapillary and parafoveal blood flow index and vessel density. The studies as the following aspects: At first, the POAG with early, middle, and late stages. These indices of blood flow index and vessel density in each stage of POAG gradually decreased. Results showed well diagnostic efficacy of blood flow index and vessel density for POAG. Then, we studied the eyes with acute attacks of PACG after one month when IOP controlled. Results showed the density of peripapillary vessels in PACG decreased significantly during the stages of chronic(PACG), attack(APAC), intermmitent(PAC) compared to preclinical (PACS) and normal controls. The vessel density in the macular area during chronic(PACG) stage is lower than that of normal controls. And we performed OCTA in the eyes before and 1 hour after LPI in 100 cases of PACS. Results indicated transient large IOP fluctuations have a greater impact on retinal blood flow. So, we think the glaucoma need a comprehensive treatment, in addition to lowering IOP, microcirculation should be improved, especially those with pre-existing retinal vascular disease.
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Pannet PangputhipongThailand
Speaker
Phacoemulsification: Challenging and Interesting CasesPhacoemulsification in complex cases is always challenging. Situations such as hard nucleus, intumescent cataract, posterior polar cataract, loose zonule, or small pupil require special surgical techniques to overcome the difficulties. In some patients, multiple complexities may occur simultaneously, making the procedure extremely challenging—sometimes described as a surgeon’s nightmare.
This presentation will highlight selected interesting cases and demonstrate strategies to manage them safely, guiding surgeons on how to navigate through these “war zone” scenarios with confidence.Challenges in Soft Nucleus: Don’t Drown in Shallow WaterPhacoemulsification in soft nuclei can be challenging if inappropriate techniques are used. The soft nature of the nucleus makes nuclear disassembly difficult. Chopping and rotation are not easily performed because the chopper tends to cut through the nuclear mass when cracking or rotational force is applied, without achieving satisfactory results. The phaco tip also cannot hold the nucleus firmly enough during chopping or pulling.
“Stab Test” using a 27g. hydrodissection canular to determine the hardness of the nucleus before performing hydrodissection is essential, in order to choose the most appropriate phaco technique.
Special techniques such as Hydro Subluxation + Aspiration, Hydro Subluxation + Flip & Chop, Half Bowl + Rim Aspiration, and Chip & Flip (I. Howard Fine) will be discussed, including phacodynamics for soft nuclei.
When proper techniques are applied, surgery can be performed safely and effectively.
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Vicente OcampoPhilippines
Speaker
Ocular TB: The Philippine Experience This talk aims to discuss the fine points in bringing people together to work towards achieving a common goal. It will identify the roles of an effective leader and will differentiate transactional from transformational leadership. It will also tackle the essential elements to a successful endeavor namely - Vision, Resolve, Strategy and People.
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Muiz MAHYUDINMalaysia
Speaker
Presbyopic Correction with LVC This lecture will explore the viability of laser vision correction (LVC) for presbyopia, focusing on the concepts of presby-LASIK, multifocal ablations, and blended vision strategies. We will discuss the optical compromises inherent in these approaches, such as reduced contrast sensitivity and the occurrence of halos, before reviewing current evidence on outcomes, patient satisfaction, and reported side effects. Clinical cases will be highlighted to illustrate practical applications and challenges in patient selection and counseling. Finally, we will evaluate the balance between the future potential of these techniques and their current limitations, enabling participants to describe the key surgical methods and critically appraise the available evidence regarding efficacy and safety.
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701B
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ZH
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謝宜靜 Yi-Ching HsiehTaiwan
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 Hung-Yu LinTaiwan
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 Chang-Min LiangTaiwan
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 Wei-Cheng HuangTaiwan
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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Thomas KOHNENGermany
Speaker
Power and Precision: The New Era of Phacoemulsification TechnologyBridging Cornea and Lens: The Modern Role of Phakic IOLs in a Myopic WorldFrom Awareness to Action: Stepwise Learning to Manage Capsular Rupture During Cataract Surgery
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701C
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EN
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David HuangUnited States
Speaker
OCT/OCTA Application in the Anterior SegmentOptical coherence tomography (OCT) applications in the anterior segment have lagged retinal
imaging because of the wider area and deeper structures that need to be covered, including the
cornea, anterior chamber, and crystalline lens. With recent advances in the speed and depth
range of both spectral-domain and swept-source OCT has finally hit the mainstream with many
products reaching the market in the past 5 years. Compared to Placido-disc and Scheimpflug
slit-scanning technologies, OCT offers higher depth resolution and the ability to map epithelial
thickness as well as pachymetry, anterior topography, and posterior topography. This lecture will
describe how this can be used to detect and differentiate among the major classes of corneal
diseases. Other topics that will be covered include wide-field OCT for corneoscleral topography,
OCT microscopy to see cells and pathogens, OCT biometry for intraocular lens calculations, and
OCT angiography for the evaluation of iris and ocular surface tumors.Seeing Small and Aiming Big: the Development and Clinical Impact of Optical Coherence TomographyOptical coherence tomography (OCT) is a technology invented in 1991 to image small critical tissue
structures with micrometer resolution. It is widely used in eye and coronary heart diseases. I will
tell the story of OCT’s initial conception from the inventor’s perspective along with an account of
the rapid pace of development that made OCT a clinical reality. The biggest applications of OCT in
the management of eye diseases will be shown. Recent advances that enable OCT to advance
beyond the imaging of tissue structure to the detection of blood flow and photoreceptor function
will be described. The roles of academia, industry, and government agencies in the clinical
translation of OCT will be highlighted.
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陳偉勵 Wei-Li ChenTaiwan
Speaker
Using AS-OCT with epithelial thickness mapping and a self-developed stromal thickness map to detect early corneal ectasia and prevent postoperative ectasia following refractive surgeryEarly detection of subclinical corneal ectasia remains one of the most critical challenges in managing ophthalmic diseases and performing modern corneal refractive surgery. Advances in anterior segment optical coherence tomography (AS-OCT) have enabled highly detailed assessment of corneal microstructure, particularly through epithelial thickness mapping, which often reveals subtle compensatory remodeling before stromal abnormalities become clinically apparent. In this study and clinical application series, we introduce—and precisely apply—epithelial thickness mapping together with our team’s newly developed **corneal stromal thickness difference map** to further enhance the sensitivity of ectasia screening.
This lecture summarizes our team’s recently published work as well as upcoming research, with a focus on how these innovative imaging approaches allow for **early detection of corneal ectasia**, even before topographic changes emerge. Our difference map quantifies disparities between epithelial masking patterns and stromal surface alterations, enabling clinicians to identify early biomechanical instability that is often invisible on conventional topography or tomography.
Through this presentation, attendees will gain a deeper understanding of the latest clinical applications of AS-OCT epithelial mapping and how these advanced tools can be integrated into routine practice to more effectively detect, manage, and prevent hidden or subclinical corneal ectasia. These innovations provide additional structural insight that supports more accurate refractive surgical planning and contributes to improved long-term corneal stability.
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Shigeru KinoshitaJapan
Speaker
Toward Corneal Regenerative MedicineSevere ocular surface and corneal disorders—including Stevens-Johnson syndrome, chemical injury, ocular cicatricial pemphigoid, Fuchs endothelial corneal dystrophy (FECD), and advanced corneal endothelial failure—remain difficult to manage. Recent advances in ocular surface biology and regenerative medicine have enabled the development of transplantable epithelial sheets, such as allogeneic/autologous corneal epithelial stem-cell sheets, autologous cultivated oral mucosal epithelial sheets (COMET), and iPSC-derived corneal epithelial sheets, some of which have received regulatory approval from the EMA and PMDA.
Corneal endothelial dysfunction is also being addressed through regenerative medicine approaches. The transplantation (via injection) of mature, differentiated cultured human corneal endothelial cells (CHCEC) combined with a ROCK inhibitor into the anterior chamber has demonstrated favorable efficacy and safety, leading to PMDA approval in 2023 and subsequent clinical application in Japan beginning in September 2024. In addition, ROCK-inhibitor eye drops have demonstrated potential in treating early-stage endothelial dysfunction in FECD.
Continued progress in corneal regenerative therapies promises to advance global regulatory acceptance and contribute meaningfully to the prevention of blindness worldwide.
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Shigeru KinoshitaJapan
Speaker
Toward Corneal Regenerative MedicineSevere ocular surface and corneal disorders—including Stevens-Johnson syndrome, chemical injury, ocular cicatricial pemphigoid, Fuchs endothelial corneal dystrophy (FECD), and advanced corneal endothelial failure—remain difficult to manage. Recent advances in ocular surface biology and regenerative medicine have enabled the development of transplantable epithelial sheets, such as allogeneic/autologous corneal epithelial stem-cell sheets, autologous cultivated oral mucosal epithelial sheets (COMET), and iPSC-derived corneal epithelial sheets, some of which have received regulatory approval from the EMA and PMDA.
Corneal endothelial dysfunction is also being addressed through regenerative medicine approaches. The transplantation (via injection) of mature, differentiated cultured human corneal endothelial cells (CHCEC) combined with a ROCK inhibitor into the anterior chamber has demonstrated favorable efficacy and safety, leading to PMDA approval in 2023 and subsequent clinical application in Japan beginning in September 2024. In addition, ROCK-inhibitor eye drops have demonstrated potential in treating early-stage endothelial dysfunction in FECD.
Continued progress in corneal regenerative therapies promises to advance global regulatory acceptance and contribute meaningfully to the prevention of blindness worldwide.
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馬惠康 David Hui-Kang MaTaiwan
Speaker
Cultivated Oral/Nasal Mucosal Epithelial Sheets for Ocular Surface Reconstruction in TaiwanBackground
To investigate the in vivo epithelial phenotypes of cultivated nasal mucosal epithelial cell (CUNMEC) sheets generated by a microspheroidal suspension culture technique.
Methods
Human nasal mucosal tissues were obtained during DCR. The tissues were digested with 2 mg/mL collagenase A, then the cell aggregates were seeded onto a de-epithelialized AM and cultivated for 2 weeks. The CUNMEC sheets were then transplanted into New Zealand albino rabbits. The animals were subjected to immunosuppression for two weeks and then sacrificed. The samples were subjected to light and electron microscopy (EM) and immunoconfocal microscopy examinations.
Results
The presence of CUNMECs in rabbit eyes was confirmed by anti-human cytoplasmic
antibody staining. Keratins 3, 4, and 13 were positively expressed in the suprabasal
region, whereas p63 expression was observed only in the basal layer. Transmission
EM revealed stratified epithelium with the formation of desmosomes and
hemidesmosomes. Scanning EM revealed a cobble stone-like epithelial surface
without cilia formation. α-Tubulin, a major component of cilia, was expressed only in
the apical region of the nasal mucosa and showed diffuse cytoplasmic staining in the
CUNMEC sheets. ZO-1, a component of tight junctions, was expressed in the apical
region of the nasal mucosa and was expressed at intercellular borders in CUNMECs.
Conclusion
Following transplantation, the CUNMEC sheet presented a stratified epithelial layer
containing GCs but without cilia and expressed progenitor cell markers, which are
morphologically similar to those of ocular surface epithelia and may have the potential to function as a surrogate epithelium for ocular surface reconstruction, especially in dry eye conditions.
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701D
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ZH
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蔡紫薰 Tzu-Hsun TsaiTaiwan
Moderator
Facts and Myths: What We Need to Know About Atropine Eye DropsA study conducted in Taiwan during the 1990s demonstrated that atropine reduced myopia progression in a dose-dependent manner. Since that time, the clinical use of atropine in school-aged children has been widespread in Taiwan for more than two decades. Owing to this long history of high-concentration atropine prescriptions, Taiwan represents a distinctive setting in which to evaluate the long-term safety of atropine use. Using data from a large cohort within the NHIRD, we found that the incidence of ocular complications was higher among individuals with myopia compared with those without. However, among participants with myopia, the incidence of these complications did not differ between atropine users and nonusers, and higher cumulative doses of atropine were not associated with increased risk.
The long-term efficacy of atropine eye drops for myopia control also merits further investigation. The LAMP clinical trial demonstrated that continuous treatment with 0.05% atropine effectively controlled myopia progression over five years. In contrast, the ATLAS from Singapore reported that topical atropine use during childhood was not associated with long-term ocular complications; however, its long-term efficacy in myopia control was less conclusive. Furthermore, recent randomized clinical trials have yielded inconsistent findings regarding the effectiveness of low-dose atropine, and regulatory approval by the U.S. FDA remains pending. Further research is therefore warranted to refine atropine treatment strategies, including the optimal timing of initiation, adjustment of concentration, duration of therapy, and methods and timing of discontinuation. Most importantly, future work should aim to clarify the ultimate clinical significance and long-term benefits of atropine therapy for myopia control.
接軌國際：IMI 近視前期定義與台灣經驗分享Pre-myopia is an emerging concept in myopia prevention, referring to children within a specific age range who exhibit refractive errors that, along with certain risk factors, place them at increased risk of developing myopia and who may benefit from early intervention. This presentation focuses on the international definitions of pre-myopia and utilizes public health survey data and clinical evidence from Taiwan to analyze the prevalence of pre-myopia and explore issues related to myopia development.
林慧茹 Hui-Ju LinTaiwan
Moderator
Advances in Artificial Intelligence Models and Algorithms in Amblyopia and Strabismus Review of Artificial Intelligence (AI) models that detect strabismus and amblyopia risk factors from smartphone photos, videos, and images, facilitating large-scale, accessible community screening. Discussion on how AI is personalizing amblyopia therapy, thereby maximizing efficacy and engagement. Critical appraisal of the requirements for clinical validation, regulatory approval, and the ethical integration of these AI tools into standard ophthalmic practice.
AI is poised to fundamentally reshape the management of strabismus and amblyopia by introducing unprecedented levels of objectivity, accessibility, and personalization. the knowledge to understand, evaluate, and eventually integrate these powerful technologies into their practice to improve patient outcomes. AI screening and diagnosis to treatment optimization and monitoring.
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潘志勤 Chih-Chin PanTaiwan
Speaker
眼科醫師在校園視力保健及公共衛生推廣中的角色摘要
眼科醫師在校園視力保健及公共衛生推廣中，扮演著遠超過「診療者」的多元且關鍵角色。他們是整個視力保健體系中的專家、倡議者、教育者與把關者。
眼科醫師在此領域中的多重角色：
一、 校園視力保健中的直接角色
在校園這個第一線場域，眼科醫師的角色從被動治療轉為主動出擊。
二、 公共衛生推廣中的核心角色
在更宏觀的公衛層面，眼科醫師是政策與民眾之間的橋樑，是推動全民視覺健康的引擎。
總結
眼科醫師在校園視力保健與公衛推廣中的角色，已從傳統的「醫療端」向前延伸至「預防端」和「政策端」。對於提升整體國民的視覺健康與生活品質，及一個國家的公共衛生和發展至關重要。
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蔡德中 Der-Chong TsaiTaiwan
Speaker
豪雅光學近視控制鏡片 (Hoya MiYOSMART)為減緩兒童近視度數的進展，除了藥物、環境與行為策略，近年來還有多種光學介入方式可供選擇。 而這些光學措施主要是基於「周邊近視性離焦能抑制眼軸伸長」的實驗證據。
其中，DIMS（Defocus Incorporated Multiple Segments）鏡片為目前在臨床上研究最多的框架眼鏡技術。其核心設計為在鏡片中心光學區(直徑為9mm)的周邊，配置 396 個具有正3.5D的鏡片小區塊，形成持續性的近視性離焦刺激，以抑制眼軸增長。多項臨床研究顯示，相較於傳統單焦點眼鏡，DIMS 鏡片在減緩近視進展、控制眼軸伸長以及兒童配戴的耐受性方面均具有顯著優勢。本演講 將討論DIMS對於學齡前近視預防的可行性，並聚焦在對於DIMS反應不理想的個案處理。
卡爾蔡司成長睿鏡片 (Zeiss MyoCare)本演講為卡爾蔡司成長睿鏡片的第二部分，主要報告MyoCare與MyoCare S於歐洲與亞洲兒童族群 多中心、隨機對照臨床試驗結果，
歐洲 CEME 研究納入 234 名 6–13 歲兒童，配戴 MyoCare 一年後，相較單光眼鏡，近視度數進展減少 0.21 D、眼軸增長減少 0.14 mm，並顯著降低快速惡化者的比例（SE > −0.50D/yr：21.1% vs 39.3%）。中國 240 名兒童的雙盲隨機試驗顯示，在 12 個月與 24 個月的追蹤中，MyoCare 與 MyoCare S 均較單光眼鏡能顯著減緩眼軸延長及屈光度近視化的速度。12 個月時，MyoCare 與 MyoCare S 分別減少眼軸延長 41% 與 34%，並減緩近視進展 48% 與 45%。24 個月結果同樣顯示穩定的控制效果，眼軸延長分別減少 38% 與 28%。此外，以「Emmetropic Progression Ratio」分析，兩款鏡片皆能使眼軸生長趨近正視化發展，MyoCare 與 MyoCare S 的比率分別達 70% 與 68%。兩種設計在整體控制效果上相近，亦展現高度安全性與良好配戴順應性。綜合而言，MyoCare 與 MyoCare S鏡片具備良好視力品質，不論在亞洲或歐洲族群皆能有效減緩眼軸生長，使眼球發育更接近正視化軌跡，是目前具跨族群證據支持的近視控制鏡片解決方案。
眼科醫師在校園視力保健及公衛推廣中的角色面對近視狂潮，眼科醫師在校園視力保健與公衛推廣中扮演關鍵角色: Partner, Educator, Advisor。近視防治有兩大策略：延後近視發生（近視預防） 與 減緩進展（近視控制），其中近視控制主要在診間進行，而近視預防則必須走入校園。以宜蘭縣模式為例，由眼科醫師到園所進行散瞳驗光檢查，可達 92% 的大班幼兒篩檢率，顯示其優於學童自行就醫。散瞳驗光能找出視力正常的低度近視與近視前期，凸顯眼科專業在校園篩檢中的必要性。 眼科醫師同時是 宣傳視力保健知識的教育者，除了在校園演講推動「天天戶外 120 分鐘」、近視控制新知等實證策略、支持教師與校護成為對抗近視前線的重要夥伴。我們亦可針對近視前期兒童的家長，透過社群平台以圖像化、影音化內容，精準推廣正確近視衛教，促進高近視風險學童與家長的警覺心與配合度。此外，眼科醫師也能是 政策建言者。過去十多年來，眼科醫師持續協助衛政與教育單位制定重要政策，包括 2009 年全國天天戶外120政策、2013 年北市國小近視篩檢、2014 年宜蘭縣幼兒園到校散瞳驗光、2022 年宜蘭縣近視前期大班轉介方案，以及 2023 年宜蘭縣國小視力紀錄卡向下延伸至幼兒園。本演講將分享眼科醫師在校園視力保健與公衛推廣參與者、教育者與建言者 的三重的角色。
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蔡紫薰 Tzu-Hsun TsaiTaiwan
Speaker
Facts and Myths: What We Need to Know About Atropine Eye DropsA study conducted in Taiwan during the 1990s demonstrated that atropine reduced myopia progression in a dose-dependent manner. Since that time, the clinical use of atropine in school-aged children has been widespread in Taiwan for more than two decades. Owing to this long history of high-concentration atropine prescriptions, Taiwan represents a distinctive setting in which to evaluate the long-term safety of atropine use. Using data from a large cohort within the NHIRD, we found that the incidence of ocular complications was higher among individuals with myopia compared with those without. However, among participants with myopia, the incidence of these complications did not differ between atropine users and nonusers, and higher cumulative doses of atropine were not associated with increased risk.
The long-term efficacy of atropine eye drops for myopia control also merits further investigation. The LAMP clinical trial demonstrated that continuous treatment with 0.05% atropine effectively controlled myopia progression over five years. In contrast, the ATLAS from Singapore reported that topical atropine use during childhood was not associated with long-term ocular complications; however, its long-term efficacy in myopia control was less conclusive. Furthermore, recent randomized clinical trials have yielded inconsistent findings regarding the effectiveness of low-dose atropine, and regulatory approval by the U.S. FDA remains pending. Further research is therefore warranted to refine atropine treatment strategies, including the optimal timing of initiation, adjustment of concentration, duration of therapy, and methods and timing of discontinuation. Most importantly, future work should aim to clarify the ultimate clinical significance and long-term benefits of atropine therapy for myopia control.
接軌國際：IMI 近視前期定義與台灣經驗分享Pre-myopia is an emerging concept in myopia prevention, referring to children within a specific age range who exhibit refractive errors that, along with certain risk factors, place them at increased risk of developing myopia and who may benefit from early intervention. This presentation focuses on the international definitions of pre-myopia and utilizes public health survey data and clinical evidence from Taiwan to analyze the prevalence of pre-myopia and explore issues related to myopia development.
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