林宣君 Shan-Jiun Lin

Time	Session

08:20 12:00	眼瞼及眼窩專題演講會｜Eyelid and Orbital Symposium EN 眼瞼及眼窩專題演講會 Eyelid and Orbital Symposium 蔡悅如 Yueh-Ju TsaiTaiwan Moderator Transcanalicular Diode Laser Assisted DacryocystorhinostomyTranscanalicular laser dacryocystorhinostomy is a minimally invasive surgical intervention for nasolacrimal duct obstruction. The procedure involves creating a direct osteotomy by advancing a laser fiber through the canaliculus to ablate the bone and soft tissue separating the lacrimal sac from the nasal cavity. This approach offers distinct advantages, including the absence of cutaneous scarring, superior hemostasis, and preservation of the physiological lacrimal pump mechanism; it also serves as an effective salvage technique for failed DCRs. We utilized an 810-nm diode laser, and a video demonstration of the intraoperative technique will be presented. Due to the reduced operative time and minimal bleeding, this procedure is well-suited for local anesthesia, making it particularly advantageous for elderly patients. 蘇姵元 Pei-Yuan SuTaiwan Moderator 許紋銘 Wen-Ming HsuTaiwan Moderator Nonspecific Idiopathic Orbital Inflammation Update 胡佩欣 Pei-Shin HuTaiwan Speaker Nonspecific Orbital Inflammation UpdateNonspecific orbital inflammation (NSOI) remains one of the most challenging diagnostic entities in orbital disease due to its heterogeneous presentation and overlap with infectious, autoimmune, and neoplastic conditions. Traditionally considered a diagnosis of exclusion, NSOI now benefits from emerging imaging criteria, structured diagnostic algorithms, and increasing evidence supporting individualized management. This presentation integrates data from recent guideline development and a large evidence-based clinical cohort to provide a concise and practical framework for clinicians. Key components include updated classification systems, the role of MRI with diffusion-weighted imaging in differentiating NSOI from lymphoma or IgG4-related disease, and indications for biopsy when clinical or radiologic features are atypical or treatment response is inconsistent. Treatment strategies emphasize corticosteroid response patterns, recurrence predictors, and escalation pathways incorporating immunosuppressants, biologics such as rituximab, and selective radiotherapy. By combining high-level evidence with annotated imaging examples and treatment algorithms, this lecture aims to support accurate diagnosis, avoid misclassification, and improve long-term outcomes in patients with NSOI, especially those with recurrent or steroid-dependent disease. Endoscopic Removal of Orbital Apex Mass 涂云海 Yunhai TuChina Speaker Endoscopic removal of orbital apex massThe orbital apex mass has always been a difficult point in orbital surgery. The anatomical space of the orbital apex is narrow, and transorbital surgery often leads to serious complications, even blindness. We have been committed to minimally invasive ophthalmic endoscopic surgery. Endoscopic transnasal surgery has opened up a new world for the removal of orbital apex tumors, and we gradually mastered the operation of dual instruments with both hands under endoscopy by one doctor. However, there is still no solution for the orbital apex mass upper lateral of the optic nerve . We designed a surgical approach combining endoscopic transnasal and transperiosteal space surgery. Starting from the foreign body in the orbital apex, continuous practice has been carried out to successfully remove the orbital apex mass upper lateral of the optic nerve. Thus, we have achieved a complete surgical system for endoscopic removal of orbital apex mass Computer-Assisted Navigation in Orbital Surgery 蔡傑智 Chieh-Chih TsaiTaiwan Speaker Computer-Assisted Navigation in Orbital SurgeryOrbital surgery presents unique challenges due to the complex anatomy of the orbit and the close proximity of vital structures such as the optic nerve and extraocular muscles. Traditional freehand approaches rely heavily on surgical experience and anatomical estimation, which can limit precision in complex orbital surgery. Computer-assisted navigation (CAN) has emerged as a transformative tool to enhance surgical accuracy, safety, and predictability. This lecture will explore the principles and clinical applications of computer-assisted navigation in orbital surgery. Topics include image acquisition and 3D reconstruction, preoperative virtual planning, and real-time intraoperative guidance. Case examples will illustrate its use in orbital fracture repair, decompression for thyroid eye disease, and tumor excision. Patient-specific implants designed through advanced three-dimensional (3D) imaging, computer-aided design and computer-aided manufacturing will also be presented. In conclusion CAN has bridged radiologic imaging and operative execution, providing a safer and more precise approach to orbital surgery. Transforming TED Management: The Rise of Targeted Therapies and What the Evidence Tells Us 魏以宣 Yi-Hsuan WeiTaiwan Speaker Transforming TED Management: The Rise of Targeted Therapies and What the Evidence Tells UsTreatment for thyroid eye disease (TED) has changed greatly with the development of new targeted biologic therapies. Research on IGF-1R, IL-6, and other potential targets for biologic therapy has been extensive in recent years. This talk will review how these therapies work, summarize key clinical findings, and share real-world experience. By combining current evidence and clinical insights, we will explore how targeted treatments are improving outcomes and transforming the management of TED. Update of Ocular Adnexal Lymphomas Sarah CouplandUnited Kingdom Speaker Uveal melanoma prognostication: beyond chromosome 3Prognosis for uveal melanoma (UM) is determined by a combination of clinical, histopathological, and molecular factors. Clinical markers include tumour size and location, while histopathological factors include cell type and mitotic activity. The Liverpool Ocular Oncology Centre has a long track record in UM prognostication, and has devised an algorithm (LUMPO3) for more precise risk stratification and identifying patients at high risk for metastasis. It is a multiparametric model, which also included genetic data, particularly chromosome 3 and 8. It has been demonstrated that BAP1 immunohistochemistry is a very close surrogate for the status of the BAP1 gene, which if mutated is associated with a poor prognosis in UM. Our recent work has investigated the inclusion of BAP1 immunohistochemistry in LUMPO3, in labs where chromosomal analysis is not available. Early detection of metastatic UM is critical, as the prognosis is poor once widespread metastases develop. If detected earlier, surgical and newer immunotherapy options have been demonstrated to prolong survival.Decoding intraocular masqueradeIntraocular lymphomas can be divided into 3 main subtypes: primary vitreoretinal lymphoma (VRL), primary choroidal lymphoma, and secondary intraocular lymphoma. VRL is a rare but aggressive form of non-Hodgkin lymphoma that affects the eye. The most common subtype is a Diffuse large cell B-cell lymphoma (DLBCL), and displays a similar morphology, immuno- and genetic profile to the primary CNS lymphomas. Indeed, VRL can relapse in the CNS, and similarly CNSL can involve the eye. VRL often "masquerades" as chronic uveitis, making early and accurate diagnosis challenging but crucial for effective treatment and improved prognosis. In contrast, primary choroidal lymphoma is an indolent non-Hodgkin lymphoma similar to the Marginal Zone B-cell lymphomas of the ocular adnexa, and do not spread to the CNS. This lecture will provide an update about the biology, diagnostics and treatment of VRL and choroidal lymphomas. It will also provide examples of differential diagnoses to consider in vitrectomy specimens.Update of Ocular Adnexal LymphomasOcular adnexal lymphomas are most commonly non-Hodgkin lymphomas (NHL) that develop in the conjunctiva, eyelid, lacrimal gland, and orbit. The most common subtype is an extranodal marginal zone lymphoma (EMZL), which often presents as a painless, salmon-coloured lesion on the conjunctiva or as a mass causing symptoms like proptosis, double vision, or swelling in the orbit. Other common NHL of the ocular adnexa include follicular lymphomas, diffuse large cell B-cell lymphomas and mantle cell lymphomas. Treatment varies as per lymphoma subtype and requires joined-up assessment with the haematologists and radiologists. Typically treatment is local with low-dose radiation therapy being a standard option for localised disease, while systemic treatment may be used for more advanced cases. This lecture will provide an update about the biology, diagnostics and treatment of ocular adnexal lymphomas. Precise Repair of Complex Orbital Fractures (Pre-recorded Video) 盧葦 Wei LuChina Speaker Precise Repair of Complex Orbital FracturesZygomatic-orbito-maxillary fracture is a kind of complex orbital fracture with high morbidity, which can lead to severe physical dysfunction and deformity. The orbital mechanical environment has great influence on the fracture repair and reconstruction. If the internal fixation is not consistent with the mechanical environment after the reconstruction, it is easy to lead to complications such as poor fracture healing, implant deformation, malposition and even breakage, which not only bring trouble to patients, but also increase financial burden. This study developed finite element models of absorbable material and titanium material for repair and fixation, respectively. By applying a force of 120 N to the model to simulate the masseter muscle strength, the maximum stress and displacement of the repair materials and the fracture ends were measured. In discussing various models, the maximum stress values of absorbable and titanium materials are less than their yield strength, and the maximum displacement values of the titanium material and fracture end were less than 0.1 mm and 0.2 mm. The maximum displacement values of absorbable material and fracture end in incomplete zygomatic fracture and dislocation were less than 0.1 mm and 0.2 mm. While in the zygomatic complex complete fractures and dislocation, the maximum displacement values of the absorbable material and the fracture end exceeded 0.1 mm and 0.2 mm. In this study, the finite element biomechanical analysis method improved the operative success ratio of zygomatic-orbito-maxillary fracture and reduced postoperative complications, which provided a new research method and objective quantitative basis for the accurate treatment. Discussion 眼瞼及眼窩專題演講會 Eyelid and Orbital Symposium 張丞賢 Cheng-Hsien ChangTaiwan Moderator 廖述朗 Shu-Lang LiaoTaiwan Moderator 褚晏彰 Yen-Chang ChuTaiwan Moderator Anatomical Nuances and Surgical Finesse in Asian Upper Blepharoplasty Kyung In Woo Speaker Anatomical Nuances and Surgical Finesse in Asian Upper BlepharoplastyAsian upper blepharoplasty, in our experience, benefits significantly from a profound understanding of the unique anatomical characteristics that distinctly differ from those of Caucasian eyelids. This lecture will focus on the subtle anatomical variations in the Asian eyelid, emphasizing the critical role of meticulous preoperative analysis and planning in achieving successful and natural-looking results. We will delve into key anatomical elements, including hidden ptosis, variations in eyelid heaviness, and epicanthus. Throughout this presentation, we aim to explore various surgical techniques specifically designed to meet the aesthetic expectations of Asian patients while maintaining functional stability. Furthermore, we will share some refined surgical finesse and considerations aimed at minimizing complications and maximizing natural outcomes. We will also share the practical strategies and techniques for addressing complications that can result from blepharoplasty. This lecture is designed to provide insights for ophthalmologists seeking to enhance their anatomical knowledge and surgical proficiency in Asian upper blepharoplasty. Transcanalicular Diode Laser Assisted Dacryocystorhinostomy 蔡悅如 Yueh-Ju TsaiTaiwan Speaker Transcanalicular Diode Laser Assisted DacryocystorhinostomyTranscanalicular laser dacryocystorhinostomy is a minimally invasive surgical intervention for nasolacrimal duct obstruction. The procedure involves creating a direct osteotomy by advancing a laser fiber through the canaliculus to ablate the bone and soft tissue separating the lacrimal sac from the nasal cavity. This approach offers distinct advantages, including the absence of cutaneous scarring, superior hemostasis, and preservation of the physiological lacrimal pump mechanism; it also serves as an effective salvage technique for failed DCRs. We utilized an 810-nm diode laser, and a video demonstration of the intraoperative technique will be presented. Due to the reduced operative time and minimal bleeding, this procedure is well-suited for local anesthesia, making it particularly advantageous for elderly patients. From Injections to the Operating Table: Surgical Management of Blepharospasm or Hemifacial Spasm 吳淑雅 Shu-Ya WuTaiwan Speaker From Injections to the Operating Table: Surgical Management of Benign Essential Blepharospasm Benign essential blepharospasm (BEB) is an adult-onset focal dystonia characterized by involuntary spasms of the periocular muscles, resulting in forced eyelid closure. Because the pathogenesis of BEB remains unclear, current management primarily aims at symptomatic relief. Botulinum toxin injection remains the first-line therapy, while surgical intervention is considered for patients with poor response to injections, or for those with eyelid deformities secondary to blepharospasm. Protractor myectomy can be performed as either a full or limited procedure. Currently, limited myectomy is preferred due to its superior cosmetic outcomes and lower complication rates. In addition, combining limited myectomy or eyelid corrective surgery with botulinum toxin injections can further optimize clinical outcomes. Apraxia of eyelid opening (AEO) is characterized by the paradoxical co-contraction of the orbicularis oculi and levator palpebrae muscles, often necessitating surgical management. Surgical strategies may involve either a single-stage or a two-stage approach. I personally favor the two-stage approach, as performing all procedures simultaneously can be technically challenging due to a higher risk of bleeding and hematoma formation. Staging the procedures allows for adequate assessment of the initial surgical results and more precise planning of subsequent interventions. Spatial Computing and Augmented Reality in Oculoplastic Surgery: Reimagining the Surgical Field Bobby S. KornUnited States Speaker Spatial Computing and Augmented Reality in Oculoplastic Surgery: Reimagining the Surgical FieldThe emergence of spatial computing headsets like the Apple Vision Pro is reshaping surgical visualization and education. In oculoplastic surgery, where precision and anatomical complexity are paramount, these tools offer immersive, real-time access to imaging and anatomical overlays without disrupting surgical flow. Principles for Natural, Symmetric, and Reliable Double Eyelid Surgery 林宣君 Shan-Jiun LinTaiwan Speaker Principles for Natural, Symmetric, and Reliable Double Eyelid SurgeryThe fundamental principle for a natural result is the replication of the native anatomical connection between the anterior and posterior lamellae. Common issues that can produce an unnatural appearance include direct skin-to-posterior lamella fixation after orbicularis oculi muscle (OOM) disruption. Achieving symmetry extends beyond basic consistency in width and suture tension; it requires advanced adjustments based on individual patient anatomy, including levator function, eyelid thickness, and globe position (e.g., enophthalmos or proptosis). Reliability is secured by creating a stable, non-shallow fold, ensuring appropriate skin tightness, and maintaining a clear anatomical view of structures like orbital fat and the levator muscle during the procedure. The presentation also addresses common challenges and pitfalls, including the difficulty of precise measurement on aging or lax skin, the importance of patient marking in a seated position to account for gravity, and the cautious preservation of functional tissues, such as the orbicularis oculi muscle (OOM) and orbital septum, to prevent complications like lagophthalmos and facilitate potential future revisions. Discussion 701G

眼瞼及眼窩專題演講會 Eyelid and Orbital Symposium

蔡悅如 Yueh-Ju TsaiTaiwan Moderator Transcanalicular Diode Laser Assisted DacryocystorhinostomyTranscanalicular laser dacryocystorhinostomy is a minimally invasive surgical intervention for nasolacrimal duct obstruction. The procedure involves creating a direct osteotomy by advancing a laser fiber through the canaliculus to ablate the bone and soft tissue separating the lacrimal sac from the nasal cavity. This approach offers distinct advantages, including the absence of cutaneous scarring, superior hemostasis, and preservation of the physiological lacrimal pump mechanism; it also serves as an effective salvage technique for failed DCRs. We utilized an 810-nm diode laser, and a video demonstration of the intraoperative technique will be presented. Due to the reduced operative time and minimal bleeding, this procedure is well-suited for local anesthesia, making it particularly advantageous for elderly patients.

蘇姵元 Pei-Yuan SuTaiwan Moderator

許紋銘 Wen-Ming HsuTaiwan Moderator

Nonspecific Idiopathic Orbital Inflammation Update

胡佩欣 Pei-Shin HuTaiwan Speaker Nonspecific Orbital Inflammation UpdateNonspecific orbital inflammation (NSOI) remains one of the most challenging diagnostic entities in orbital disease due to its heterogeneous presentation and overlap with infectious, autoimmune, and neoplastic conditions. Traditionally considered a diagnosis of exclusion, NSOI now benefits from emerging imaging criteria, structured diagnostic algorithms, and increasing evidence supporting individualized management. This presentation integrates data from recent guideline development and a large evidence-based clinical cohort to provide a concise and practical framework for clinicians. Key components include updated classification systems, the role of MRI with diffusion-weighted imaging in differentiating NSOI from lymphoma or IgG4-related disease, and indications for biopsy when clinical or radiologic features are atypical or treatment response is inconsistent. Treatment strategies emphasize corticosteroid response patterns, recurrence predictors, and escalation pathways incorporating immunosuppressants, biologics such as rituximab, and selective radiotherapy. By combining high-level evidence with annotated imaging examples and treatment algorithms, this lecture aims to support accurate diagnosis, avoid misclassification, and improve long-term outcomes in patients with NSOI, especially those with recurrent or steroid-dependent disease.

Endoscopic Removal of Orbital Apex Mass

涂云海 Yunhai TuChina Speaker Endoscopic removal of orbital apex massThe orbital apex mass has always been a difficult point in orbital surgery. The anatomical space of the orbital apex is narrow, and transorbital surgery often leads to serious complications, even blindness. We have been committed to minimally invasive ophthalmic endoscopic surgery. Endoscopic transnasal surgery has opened up a new world for the removal of orbital apex tumors, and we gradually mastered the operation of dual instruments with both hands under endoscopy by one doctor. However, there is still no solution for the orbital apex mass upper lateral of the optic nerve . We designed a surgical approach combining endoscopic transnasal and transperiosteal space surgery. Starting from the foreign body in the orbital apex, continuous practice has been carried out to successfully remove the orbital apex mass upper lateral of the optic nerve. Thus, we have achieved a complete surgical system for endoscopic removal of orbital apex mass

Computer-Assisted Navigation in Orbital Surgery

蔡傑智 Chieh-Chih TsaiTaiwan Speaker Computer-Assisted Navigation in Orbital SurgeryOrbital surgery presents unique challenges due to the complex anatomy of the orbit and the close proximity of vital structures such as the optic nerve and extraocular muscles. Traditional freehand approaches rely heavily on surgical experience and anatomical estimation, which can limit precision in complex orbital surgery. Computer-assisted navigation (CAN) has emerged as a transformative tool to enhance surgical accuracy, safety, and predictability. This lecture will explore the principles and clinical applications of computer-assisted navigation in orbital surgery. Topics include image acquisition and 3D reconstruction, preoperative virtual planning, and real-time intraoperative guidance. Case examples will illustrate its use in orbital fracture repair, decompression for thyroid eye disease, and tumor excision. Patient-specific implants designed through advanced three-dimensional (3D) imaging, computer-aided design and computer-aided manufacturing will also be presented. In conclusion CAN has bridged radiologic imaging and operative execution, providing a safer and more precise approach to orbital surgery.

Transforming TED Management: The Rise of Targeted Therapies and What the Evidence Tells Us

魏以宣 Yi-Hsuan WeiTaiwan Speaker Transforming TED Management: The Rise of Targeted Therapies and What the Evidence Tells UsTreatment for thyroid eye disease (TED) has changed greatly with the development of new targeted biologic therapies. Research on IGF-1R, IL-6, and other potential targets for biologic therapy has been extensive in recent years. This talk will review how these therapies work, summarize key clinical findings, and share real-world experience. By combining current evidence and clinical insights, we will explore how targeted treatments are improving outcomes and transforming the management of TED.

Update of Ocular Adnexal Lymphomas

Sarah CouplandUnited Kingdom Speaker Uveal melanoma prognostication: beyond chromosome 3Prognosis for uveal melanoma (UM) is determined by a combination of clinical, histopathological, and molecular factors. Clinical markers include tumour size and location, while histopathological factors include cell type and mitotic activity. The Liverpool Ocular Oncology Centre has a long track record in UM prognostication, and has devised an algorithm (LUMPO3) for more precise risk stratification and identifying patients at high risk for metastasis. It is a multiparametric model, which also included genetic data, particularly chromosome 3 and 8. It has been demonstrated that BAP1 immunohistochemistry is a very close surrogate for the status of the BAP1 gene, which if mutated is associated with a poor prognosis in UM. Our recent work has investigated the inclusion of BAP1 immunohistochemistry in LUMPO3, in labs where chromosomal analysis is not available. Early detection of metastatic UM is critical, as the prognosis is poor once widespread metastases develop. If detected earlier, surgical and newer immunotherapy options have been demonstrated to prolong survival.Decoding intraocular masqueradeIntraocular lymphomas can be divided into 3 main subtypes: primary vitreoretinal lymphoma (VRL), primary choroidal lymphoma, and secondary intraocular lymphoma. VRL is a rare but aggressive form of non-Hodgkin lymphoma that affects the eye. The most common subtype is a Diffuse large cell B-cell lymphoma (DLBCL), and displays a similar morphology, immuno- and genetic profile to the primary CNS lymphomas. Indeed, VRL can relapse in the CNS, and similarly CNSL can involve the eye. VRL often "masquerades" as chronic uveitis, making early and accurate diagnosis challenging but crucial for effective treatment and improved prognosis. In contrast, primary choroidal lymphoma is an indolent non-Hodgkin lymphoma similar to the Marginal Zone B-cell lymphomas of the ocular adnexa, and do not spread to the CNS. This lecture will provide an update about the biology, diagnostics and treatment of VRL and choroidal lymphomas. It will also provide examples of differential diagnoses to consider in vitrectomy specimens.Update of Ocular Adnexal LymphomasOcular adnexal lymphomas are most commonly non-Hodgkin lymphomas (NHL) that develop in the conjunctiva, eyelid, lacrimal gland, and orbit. The most common subtype is an extranodal marginal zone lymphoma (EMZL), which often presents as a painless, salmon-coloured lesion on the conjunctiva or as a mass causing symptoms like proptosis, double vision, or swelling in the orbit. Other common NHL of the ocular adnexa include follicular lymphomas, diffuse large cell B-cell lymphomas and mantle cell lymphomas. Treatment varies as per lymphoma subtype and requires joined-up assessment with the haematologists and radiologists. Typically treatment is local with low-dose radiation therapy being a standard option for localised disease, while systemic treatment may be used for more advanced cases. This lecture will provide an update about the biology, diagnostics and treatment of ocular adnexal lymphomas.

Precise Repair of Complex Orbital Fractures (Pre-recorded Video)

盧葦 Wei LuChina Speaker Precise Repair of Complex Orbital FracturesZygomatic-orbito-maxillary fracture is a kind of complex orbital fracture with high morbidity, which can lead to severe physical dysfunction and deformity. The orbital mechanical environment has great influence on the fracture repair and reconstruction. If the internal fixation is not consistent with the mechanical environment after the reconstruction, it is easy to lead to complications such as poor fracture healing, implant deformation, malposition and even breakage, which not only bring trouble to patients, but also increase financial burden. This study developed finite element models of absorbable material and titanium material for repair and fixation, respectively. By applying a force of 120 N to the model to simulate the masseter muscle strength, the maximum stress and displacement of the repair materials and the fracture ends were measured. In discussing various models, the maximum stress values of absorbable and titanium materials are less than their yield strength, and the maximum displacement values of the titanium material and fracture end were less than 0.1 mm and 0.2 mm. The maximum displacement values of absorbable material and fracture end in incomplete zygomatic fracture and dislocation were less than 0.1 mm and 0.2 mm. While in the zygomatic complex complete fractures and dislocation, the maximum displacement values of the absorbable material and the fracture end exceeded 0.1 mm and 0.2 mm. In this study, the finite element biomechanical analysis method improved the operative success ratio of zygomatic-orbito-maxillary fracture and reduced postoperative complications, which provided a new research method and objective quantitative basis for the accurate treatment.

Discussion

眼瞼及眼窩專題演講會 Eyelid and Orbital Symposium

張丞賢 Cheng-Hsien ChangTaiwan Moderator

廖述朗 Shu-Lang LiaoTaiwan Moderator

褚晏彰 Yen-Chang ChuTaiwan Moderator

Anatomical Nuances and Surgical Finesse in Asian Upper Blepharoplasty

Kyung In Woo Speaker Anatomical Nuances and Surgical Finesse in Asian Upper BlepharoplastyAsian upper blepharoplasty, in our experience, benefits significantly from a profound understanding of the unique anatomical characteristics that distinctly differ from those of Caucasian eyelids. This lecture will focus on the subtle anatomical variations in the Asian eyelid, emphasizing the critical role of meticulous preoperative analysis and planning in achieving successful and natural-looking results. We will delve into key anatomical elements, including hidden ptosis, variations in eyelid heaviness, and epicanthus. Throughout this presentation, we aim to explore various surgical techniques specifically designed to meet the aesthetic expectations of Asian patients while maintaining functional stability. Furthermore, we will share some refined surgical finesse and considerations aimed at minimizing complications and maximizing natural outcomes. We will also share the practical strategies and techniques for addressing complications that can result from blepharoplasty. This lecture is designed to provide insights for ophthalmologists seeking to enhance their anatomical knowledge and surgical proficiency in Asian upper blepharoplasty.

Transcanalicular Diode Laser Assisted Dacryocystorhinostomy

蔡悅如 Yueh-Ju TsaiTaiwan Speaker Transcanalicular Diode Laser Assisted DacryocystorhinostomyTranscanalicular laser dacryocystorhinostomy is a minimally invasive surgical intervention for nasolacrimal duct obstruction. The procedure involves creating a direct osteotomy by advancing a laser fiber through the canaliculus to ablate the bone and soft tissue separating the lacrimal sac from the nasal cavity. This approach offers distinct advantages, including the absence of cutaneous scarring, superior hemostasis, and preservation of the physiological lacrimal pump mechanism; it also serves as an effective salvage technique for failed DCRs. We utilized an 810-nm diode laser, and a video demonstration of the intraoperative technique will be presented. Due to the reduced operative time and minimal bleeding, this procedure is well-suited for local anesthesia, making it particularly advantageous for elderly patients.

From Injections to the Operating Table: Surgical Management of Blepharospasm or Hemifacial Spasm

吳淑雅 Shu-Ya WuTaiwan Speaker From Injections to the Operating Table: Surgical Management of Benign Essential Blepharospasm Benign essential blepharospasm (BEB) is an adult-onset focal dystonia characterized by involuntary spasms of the periocular muscles, resulting in forced eyelid closure. Because the pathogenesis of BEB remains unclear, current management primarily aims at symptomatic relief. Botulinum toxin injection remains the first-line therapy, while surgical intervention is considered for patients with poor response to injections, or for those with eyelid deformities secondary to blepharospasm. Protractor myectomy can be performed as either a full or limited procedure. Currently, limited myectomy is preferred due to its superior cosmetic outcomes and lower complication rates. In addition, combining limited myectomy or eyelid corrective surgery with botulinum toxin injections can further optimize clinical outcomes. Apraxia of eyelid opening (AEO) is characterized by the paradoxical co-contraction of the orbicularis oculi and levator palpebrae muscles, often necessitating surgical management. Surgical strategies may involve either a single-stage or a two-stage approach. I personally favor the two-stage approach, as performing all procedures simultaneously can be technically challenging due to a higher risk of bleeding and hematoma formation. Staging the procedures allows for adequate assessment of the initial surgical results and more precise planning of subsequent interventions.

Spatial Computing and Augmented Reality in Oculoplastic Surgery: Reimagining the Surgical Field

Bobby S. KornUnited States Speaker Spatial Computing and Augmented Reality in Oculoplastic Surgery: Reimagining the Surgical FieldThe emergence of spatial computing headsets like the Apple Vision Pro is reshaping surgical visualization and education. In oculoplastic surgery, where precision and anatomical complexity are paramount, these tools offer immersive, real-time access to imaging and anatomical overlays without disrupting surgical flow.

Principles for Natural, Symmetric, and Reliable Double Eyelid Surgery

林宣君 Shan-Jiun LinTaiwan Speaker Principles for Natural, Symmetric, and Reliable Double Eyelid SurgeryThe fundamental principle for a natural result is the replication of the native anatomical connection between the anterior and posterior lamellae. Common issues that can produce an unnatural appearance include direct skin-to-posterior lamella fixation after orbicularis oculi muscle (OOM) disruption. Achieving symmetry extends beyond basic consistency in width and suture tension; it requires advanced adjustments based on individual patient anatomy, including levator function, eyelid thickness, and globe position (e.g., enophthalmos or proptosis). Reliability is secured by creating a stable, non-shallow fold, ensuring appropriate skin tightness, and maintaining a clear anatomical view of structures like orbital fat and the levator muscle during the procedure. The presentation also addresses common challenges and pitfalls, including the difficulty of precise measurement on aging or lax skin, the importance of patient marking in a seated position to account for gravity, and the cautious preservation of functional tissues, such as the orbicularis oculi muscle (OOM) and orbital septum, to prevent complications like lagophthalmos and facilitate potential future revisions.

Discussion

林宣君 Shan-Jiun Lin

Day 2 Sunday - 14 Dec 2025