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08:30
12:00
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ZH
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馬惠康 David Hui-Kang MaTaiwan
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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呂宥萱 Yu-Hsuan LuTaiwan
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 You-Ci OuTaiwan
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 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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馬惠康 David Hui-Kang MaTaiwan
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 Yi WanTaiwan
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 Hung-Chih ChenTaiwan
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 Hung-Ling HuTaiwan
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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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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