Taiwan Journal of Ophthalmology最新文献

{"title":"The new horizon of ophthalmic plastic and reconstructive surgery - From digital intelligence to precision intervention.","authors":"Kyung In Woo","doi":"10.4103/tjo.TJO-D-26-00003","DOIUrl":"https://doi.org/10.4103/tjo.TJO-D-26-00003","url":null,"abstract":"","PeriodicalId":44978,"journal":{"name":"Taiwan Journal of Ophthalmology","volume":"16 1","pages":"1-2"},"PeriodicalIF":1.2,"publicationDate":"2026-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13082797/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147700123","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An oculoplastic perspective on Transorbital Neuroendoscopic Surgery: Anatomical corridors and clinical applications.","authors":"Jessica Y Tong, Jeffrey Sung, Wiliam Machado de Andrade, WengOnn Chan, Alkis J Psaltis, Dinesh Selva","doi":"10.4103/tjo.TJO-D-25-00171","DOIUrl":"https://doi.org/10.4103/tjo.TJO-D-25-00171","url":null,"abstract":"<p><p>Transorbital neuroendoscopic surgery (TONES) has adopted an increasingly prominent role as a minimally invasive technique for the management of orbitocranial pathology. It can be applied to a range of conditions, from intraorbital lesions to complex tumors that cross the boundaries between the orbit and cranial fossa. The primary approaches include the superior lid crease incision and lateral retrocanthal incisions, with other alternatives including the precaruncular and inferior transconjunctival approaches. This review will examine the role of the oculoplastic surgeon in multidisciplinary TONES procedures. Cadaveric and clinical studies have defined anatomical corridors and demonstrated the technical feasibility and functional outcomes of providing access to the anterior and middle cranial fossae. Adjunctive maneuvers, such as a lateral orbitotomy or creation of extra-orbital portals, can be performed to improve surgical freedom and access. The choice of technique can be tailored to the type and location of pathology and surgical objectives regarding diagnosis and resection.</p>","PeriodicalId":44978,"journal":{"name":"Taiwan Journal of Ophthalmology","volume":"16 1","pages":"26-34"},"PeriodicalIF":1.2,"publicationDate":"2026-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13082805/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147699922","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dacryoendoscopy: Historical development, philosophical foundation, and clinical perspective.","authors":"Toru Suzuki, Tomoyuki Kamao, Jutaro Nakamura, Akemi Iwasaki, Nozomi Matsumura","doi":"10.4103/tjo.TJO-D-25-00167","DOIUrl":"https://doi.org/10.4103/tjo.TJO-D-25-00167","url":null,"abstract":"<p><p>Dacryoendoscopy is valuable for managing epiphora, enabling direct visualization of the lacrimal outflow system. Notably, dacryoendoscopy enhances diagnostic precision and facilitates minimally invasive treatment. Over the past three decades, its evolution has fostered a deeper understanding of endoluminal pathology, refined recanalization techniques, and expanded therapeutic indications across age groups. Importantly, dacryoendoscopy represents not only technical refinement but also a conceptual shift - from blind intervention to anatomy-based diagnosis and management. This shift reflects a deeper surgical philosophy, that visualization must precede intervention, and that humility toward unseen structures is crucial for true minimally invasive practice. This narrative review explores the device design philosophy, terminology, and clinical use of dacryoendoscopy, focusing on the Bent group's contributions and the emergence of conservative minimally invasive lacrimal surgery, which emphasizes mucosal preservation and is specifically suited for pediatric cases. The Bent probe endoscopes, originating in Japan, have become the most widely used devices in Asia. Moreover, false passage was illustrated in relation to the duct lumen remnant within fibrous blockage, and key techniques, including sheath-guided endoscopic probing and sheath-guided intubation, were reviewed. Regardless of these advances, challenges such as long-term deterioration of surgical outcomes and the distant goal of mucosal regeneration persist. Relevant literature was identified through a nonsystematic search of PubMed and Ichushi-Web, using the keywords \"dacryoendoscopy,\" \"nasolacrimal duct,\" and \"false passage,\" covering publications from 1995 to 2025.</p>","PeriodicalId":44978,"journal":{"name":"Taiwan Journal of Ophthalmology","volume":"16 1","pages":"44-57"},"PeriodicalIF":1.2,"publicationDate":"2026-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13082800/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147700060","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Epidemiology and follow-up adherence of ophthalmic emergencies: A 10-year study at a tertiary medical center in Taiwan.","authors":"Tsung-Ying Tsai, Chunya Kang, Laura Liu, Nan-Kai Wang, Kuan-Jen Chen, Wei-Chi Wu, Chi-Chun Lai, Sunir J Garg, Eugene Yu-Chuan Kang, Yih-Shiou Hwang","doi":"10.4103/tjo.TJO-D-25-00134","DOIUrl":"https://doi.org/10.4103/tjo.TJO-D-25-00134","url":null,"abstract":"<p><strong>Purpose: </strong>The purpose of the study was to evaluate factors influencing outpatient follow-up adherence among patients receiving ophthalmology consultations in the emergency department (ED).</p><p><strong>Materials and methods: </strong>This retrospective cohort study collected data from the Chang Gung Research Database. Patients who received ophthalmology consultations at the ED of Chang Gung Memorial Hospital Linkou Medical Center from January 1, 2010, to December 31, 2019, were included. Patients were divided into two groups based on whether they completed outpatient follow-up within 28 days, a timeframe consistent with our hospital's scheduling policy. Demographics, ED visit timing, triage categories, ophthalmic diagnoses, prior visits, and ED stay durations were analyzed using logistic regression.</p><p><strong>Results: </strong>A total of 42,530 patients were included (mean age 38.6 ± 20.2 years; 59.2% male), with 38.4% adhering to follow-up and 61.6% not. Nonadherence was associated with younger age (odds ratio [OR]: 0.92; 95% confidence interval [CI]: 0.92-0.93), evening (OR: 1.28; 95% CI: 1.22-1.34) or midnight (OR: 1.94; 95% CI: 1.83-2.06) ED visits, not likely emergent diagnoses (OR: 2.09; 95% CI: 1.96-2.22), and shorter ED stays (<1 h: OR: 3.73; 95% CI: 3.46-4.03). Patients with prior ophthalmology outpatient visits (OR: 0.48; 95% CI: 0.46-0.52) and longer ED stays (more than 3 h) demonstrated better adherence. Over 10 years, emergent diagnoses increased from 51.1% to 69.5%, while non-emergent diagnoses declined from 23.1% to 13.2%.</p><p><strong>Conclusion: </strong>Adherence to outpatient follow-up after ophthalmic ED visits was low. Younger age, evening or midnight visits, non-emergent diagnoses, and short ED stays predicted non-adherence, whereas prior outpatient visits and longer ED stays improved adherence.</p>","PeriodicalId":44978,"journal":{"name":"Taiwan Journal of Ophthalmology","volume":"16 1","pages":"114-124"},"PeriodicalIF":1.2,"publicationDate":"2026-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13082795/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147700053","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"From pixels to precision: Imaging technologies shaping oculofacial plastic surgery practice.","authors":"Anne Xuan-Lan Nguyen, Merve Kulbay, Albert Y Wu","doi":"10.4103/tjo.TJO-D-25-00141","DOIUrl":"https://doi.org/10.4103/tjo.TJO-D-25-00141","url":null,"abstract":"<p><p>Recent advances in imaging technologies have transformed surgical practice, enabling more accurate diagnoses, refined perioperative planning, and improved patient outcomes. In oculofacial plastic surgery, these tools provide safer and more precise alternatives to traditional approaches, which often relied on invasive exploration or standard imaging with limited accuracy. This review summarizes the current state of imaging technologies in oculofacial plastic surgery and discusses their benefits, limitations, and challenges. Key developments include: (i) Endoscopic imaging, providing high-resolution, magnified visualization for minimally invasive procedures, particularly in lacrimal and orbital surgery, (ii) Exoscopic imaging, a 4K-three-dimensional (3D) external system enhancing precision and team collaboration in microsurgery, (iii) Magnetic resonance imaging offering detailed 3D images of internal structures, with emerging 7T systems providing higher resolution and improved tissue contrast, (iv) Stereotactic navigation, integrating preoperative imaging with real-time tracking to guide complex orbital procedures and fracture repairs, (v) Artificial intelligence-based imaging tools, including machine learning models for disease detection, surgical planning, and outcome prediction, as well as text-to-image systems for preoperative patient counseling. Together, these technologies reduce operative risk, improve functional and esthetic outcomes, and enable patient-specific approaches. Despite challenges such as cost, accessibility, technical limitations, and learning curves, the integration of advanced imaging is steering oculofacial plastic surgery toward minimally invasive, data-driven, and patient-centered practice.</p>","PeriodicalId":44978,"journal":{"name":"Taiwan Journal of Ophthalmology","volume":"16 1","pages":"11-20"},"PeriodicalIF":1.2,"publicationDate":"2026-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13082803/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147700010","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patient-specific implants for orbital fracture surgery.","authors":"Min Kyu Yang, Ho-Seok Sa","doi":"10.4103/tjo.TJO-D-25-00152","DOIUrl":"https://doi.org/10.4103/tjo.TJO-D-25-00152","url":null,"abstract":"<p><p>Orbital wall fractures are among the most common maxillofacial injuries and require precise reconstruction to restore orbital volume, prevent diplopia, and avoid long-term sequelae such as enophthalmos or facial asymmetry. Traditional reconstruction techniques have relied on autologous grafts and preformed alloplastic implants; however, these approaches are limited by intraoperative variability, imprecise contour restoration, and increased operative time. Over the past decade, the emergence of patient-specific implants (PSIs), designed through advanced three-dimensional (3D) imaging, computer-aided design, and computer-aided manufacturing, has transformed the field of orbital reconstruction. PSIs allow highly accurate anatomical restoration, reduce intraoperative manipulation, and improve clinical outcomes. This review provides a comprehensive overview of the evolution of orbital fracture reconstruction, design and fabrication principles of PSIs, clinical evidence supporting their use, limitations, and future directions, including bioactive materials, artificial intelligence-driven design, and point-of-care 3D printing.</p>","PeriodicalId":44978,"journal":{"name":"Taiwan Journal of Ophthalmology","volume":"16 1","pages":"35-43"},"PeriodicalIF":1.2,"publicationDate":"2026-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13082806/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147700127","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Navigating the delicate balance of the transorbital approach.","authors":"Kyung In Woo, Doo-Sik Kong","doi":"10.4103/tjo.TJO-D-25-00159","DOIUrl":"https://doi.org/10.4103/tjo.TJO-D-25-00159","url":null,"abstract":"<p><p>The transorbital approach (TOA) is a significant advance in minimally invasive neurosurgery, eliminating the need for the extensive craniotomy and brain retraction typically associated with traditional methods. By accessing deep-brain and skull base lesions through a small periorbital incision, TOA significantly reduces surgical trauma, accelerates recovery, and offers superior esthetics. The well-equipped instruments and navigation system provide a magnified, meticulous view, proving effective for complex lesions near the orbital-cranial junction. However, the technique is challenged by the \"narrow passage\" and cannot be applied to all skull base lesions. Lateral orbitotomy, often performed via an upper eyelid crease incision, is a common corridor that requires careful navigation and anatomic knowledge to facilitate surgical dissection and minimize complications. Postoperative complications are usually transient, including periorbital edema, diplopia, and ptosis. Although serious long-term sequelae are rare, careful manipulation of orbital tissue and pupillary monitoring are crucial to prevent permanent nerve injury or visual impairment. TOA is a safe and valuable technique, provided there is careful patient selection and a high level of surgical expertise.</p>","PeriodicalId":44978,"journal":{"name":"Taiwan Journal of Ophthalmology","volume":"16 1","pages":"21-25"},"PeriodicalIF":1.2,"publicationDate":"2026-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13082799/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147700054","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Artificial intelligence in oculoplastics: Novel applications and future prospects.","authors":"Shiqi Hui, Dongmei Li","doi":"10.4103/tjo.TJO-D-25-00128","DOIUrl":"https://doi.org/10.4103/tjo.TJO-D-25-00128","url":null,"abstract":"<p><p>The integration of artificial intelligence (AI) into ophthalmic subspecialties, encompassing oculoplastics, is rapidly evolving. AI has demonstrated significant promise in enhancing diagnostic accuracy, streamlining clinical workflows, and personalizing surgical decisionmaking. This review aims to summarize current applications of AI in oculoplastics, identify major challenges limiting its broader adoption, and explore future directions for research and clinical translation. We provide a narrative review of peer-reviewed studies and recent developments in AI-assisted diagnosis, image analysis, surgical planning, and patient monitoring within the domain of oculoplastics. Emerging AI applications include automated detection of eyelid tumors, facial analysis for ptosis and orbital disorders, preoperative planning, and postoperative outcome assessment. However, challenges such as limited data diversity, lack of interpretability, regulatory barriers, and ethical considerations persist. AI holds great promise in augmenting oculoplastic care. Moving forward, multidisciplinary collaboration, clinical validation, and advances in multimodal learning will be key to realizing the full potential of AI in this field.</p>","PeriodicalId":44978,"journal":{"name":"Taiwan Journal of Ophthalmology","volume":"16 1","pages":"3-10"},"PeriodicalIF":1.2,"publicationDate":"2026-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13082802/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147699964","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bony realignment after surgical removal of orbital implantation cysts: A case series.","authors":"Aram Park, Kyung In Woo","doi":"10.4103/tjo.TJO-D-25-00151","DOIUrl":"https://doi.org/10.4103/tjo.TJO-D-25-00151","url":null,"abstract":"<p><p>Orbital cyst formation following previous orbital fracture surgery is an uncommon complication, yet it poses a significant concern related to permanent implant use. This complication may result in a pronounced mass effect that leads to deformation of the orbital bony walls. We present the three cases of orbital implantation cysts associated with orbital wall deformity, where bony alignment normalized after complete cyst removal. Patients exhibited ocular symptoms, including proptosis, diplopia, and hyperglobus. Surgical management involved total resection of the orbital cyst, removal of the prior implant, and placement of a new absorbable implant. Serial orbital computed tomography imaging performed over a 2-year postoperative period revealed progressive restoration of the orbital wall contour through ongoing bony realignment, with no evidence of implant migration or cyst recurrence. To the best of our knowledge, these cases provide the first documented radiological proof that bony remodeling after mass effect from an orbital implantation cyst is reversible, indicating that bone deformation caused by chronic compression can return to normal anatomy. This series underscores the necessity of thorough cyst excision and highlights the potential for anatomical correction following surgical intervention.</p>","PeriodicalId":44978,"journal":{"name":"Taiwan Journal of Ophthalmology","volume":"16 1","pages":"146-150"},"PeriodicalIF":1.2,"publicationDate":"2026-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13082813/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147700007","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating large language models for glaucoma counseling: A pilot study of ChatGPT and Google Gemini responses in Traditional Chinese.","authors":"Chen-Wei Lin, Yi-Chieh Lin, Chau-Yin Chen, Jin-Jhe Wang, Hung-Yi Lin, Ing-Chou Lai","doi":"10.4103/tjo.TJO-D-25-00058","DOIUrl":"https://doi.org/10.4103/tjo.TJO-D-25-00058","url":null,"abstract":"<p><strong>Purpose: </strong>Large language models (LLMs) such as ChatGPT and Google Gemini are increasingly used for patient education in various medical fields. However, their effectiveness in providing ophthalmology-related information in non-English languages remains underexplored. This study aimed to evaluate and compare the appropriateness of ChatGPT and Google Gemini responses to glaucoma-related questions presented in Traditional Chinese.</p><p><strong>Materials and methods: </strong>Twenty frequently asked glaucoma-related questions were translated into Traditional Chinese and categorized into four domains: disease understanding, diagnosis, treatment, and lifestyle. Responses were generated using ChatGPT (GPT-4) and Google Gemini. Three qualified ophthalmologists independently rated the appropriateness of each response using a 5-point Likert scale. Mean scores were calculated, and statistical comparisons were performed for overall and category-specific performance.</p><p><strong>Results: </strong>ChatGPT achieved a higher overall appropriateness score (4.32 ± 0.65) than Google Gemini (4.03 ± 0.66), with a statistically significant difference (<i>P</i> = 0.004). Across all four content domains, ChatGPT consistently outperformed Gemini, although the differences did not reach statistical significance. Both models demonstrated relatively lower performance in lifestyle-related questions.</p><p><strong>Conclusion: </strong>Both ChatGPT and Google Gemini are capable of providing reasonably appropriate glaucoma-related information in Traditional Chinese. ChatGPT demonstrated superior overall performance. These findings support the potential role of LLMs in enhancing patient education in non-English settings, although further improvements in language localization and domain-specific accuracy are warranted.</p>","PeriodicalId":44978,"journal":{"name":"Taiwan Journal of Ophthalmology","volume":"16 1","pages":"141-145"},"PeriodicalIF":1.2,"publicationDate":"2026-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13082811/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147699994","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}