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REFRATIVA R.I.O. course - MARCH 29th - APRIL 2nd - 2023


The whole course is translated into English and Spanish 


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03/29/2023 Wednesday


Course presentation and format


Marcony Santhiago


Propaedeutics Part I: We need to talk about all this

7:30am     Systemic conditions/medications that impact the refractive surgery candidate

Larissa Pegorin


7:50am     What I need to know about Retina and Glaucoma: Key Points

Germana Mariz


8:05am     What I need to know about Ocular Motility: Key Points

Luis Eduardo Morato Carvalho


8:20am     Structured and ethical thinking to increase surgical volume

Liane Iglesias


8:40am     Informed consent in refractive surgery

What does it mean and how to do it properly

Claudia Morgado


8:55am     Pregnancy and Refractive Surgery

Lycia Pedral

9:10am     Eye allergy and the relationship with keratoconus and refractive surgery

Denise Wajnsztajn

Propaedeutics Part II: The surface 

9:25am     Refractive surgery candidate slit lamp

Lids, transparency, dry eye, corneal diameter and other details

Luiz Fernando Chaves

9:40am     Herpes and refractive surgery: How and when to do prophylaxis

Luiz Fernando Chaves

9:50am     Does the endothelium matter?

Specular microscopy and its role in the preoperative period

Vitor Carvalho


The Invisible hand

10:00am   The economic and marketing aspects of refractive surgery

cost effectiveness

Vitor Carvalho

10:10am   History and development of Excimer Laser Refractive Surgery

John Marshall



11:00am   Dry eye epidemic?

What the new epidemiological studies show us

Monica Alves


11:10am Diagnosis of dry eye syndrome

Which Dry Eye? The case for accurate diagnostic terminology in ophthalmology

Symptoms, signs, criteria, stains and automated surface analysis

Monica Alves


11:30am Ocular Rosacea Microbiome: When and How to Use Doxycycline

Diogenes Caldeira


11:40am   Inflammatory dry eye treatment

Artificial tear vs topical anti-inflammatory

Adriana Forseto


11:50am Inflammatory dry eye treatment

Oral Medications

Harumi Burga Kuroda

12:00pm   Detailed review of new treatments for meibomitis

Pulsed Light, Thermotherapy, Oral Azithromycin, Massage and Automated Cleaning

Carolina Angeloni

12:20pm Dry eye and refractive surgery

Flowchart on how to conduct pre- and post-operatively

Monica Alves


You are in the right place at the right time

12:40pm   Prevalence of candidates and patient satisfaction in refractive surgery

Evidence they need to know

Marcony Santhiago


1:10pm LUNCH


Propaedeutics Part III: The construction of structured thinking


2:00pm   My flowchart for decision making

Refractive surgery: Understand ALL risk factors for ectasia

How to analyze studies on the risk of ectasia

Screening methods for early keratoconus

Posterior interface matter?

Conceptual explanation of all indexes: Where they come from and what they analyze

Analysis of what we have from scientific evidence and clinical practice

Marcony Santhiago


Propedeutics Part IV: Corneal Imaging

2:40pm Image of the cornea

The basics you need to know

J. Bradley Randleman


Topography module

What the corneal topography exam reveals


3:20pm   Understanding the pattern of topographic images

Risk grades for ectasia based on topography

Marcony Santhiago


4:30pm - 10:30 pm WET/DRY LABs - HANDS ON


*There will be more than 30 wet/dry labs divided into 3 time slots

4:30pm - 6:30pm

6:30pm - 8:30pm

8:30pm - 10:30pm

15 rooms during the 5 days of the course

There will also be Special Sessions with extra content.


Special Session I​

Special session at REFRATIVA R.I.O.

4:30 pm – 7:00 pm Specific Device Series

Coordination Isadora de Castilhos and Harumi Burga

4:30 Understanding Orbscan

4:50 Understanding iTrace

5:10 Understanding OPD Scan

5:30 pm Understanding Sirius

5:50 Understanding MS39

6:10 Understanding Anterion

6:30 Understanding Aladdin

03/30/2023 Thursday


Tomography Module I

Origin of indexes, rationality, theoretical aspects,

practical applicability and clinical examples

Tomography by Scheimpflug (Pentacam)

7:30am     What do they mean and how to use each of the Pentacam screens/displays

Nicole Larivoir

7:40am      Tomography through Scheimpflug (Pentacam)

Integration of Scheimpflug-Based Tomography and Biomechanical Assessments (Corvis)

Renato Ambrosio Jr.


8:00am   Belin Display - What it means, Indexes and Cutoffs

Michael Belin

8:20am      Ambrosio Display - What it means, Indexes and Cutoffs

Renato Ambrosio Jr.

8:30 am     ABCD Display

Michael Belin


8:50am      Dual Scheimpflug Tomography and Placido Disc (Galilei)

What do they mean and how to use each of the Galilei screens/displays

9:10am CLMI.X Display - Indices and Cutoffs

Maria Ximena Nunes


9:30am Elevation maps: How to use front and back interfaces seamlessly

κ angle and its effect on corneal elevation maps in refractive surgery candidates

Carlos Arce


9:50am Differences (and correlations) between Galilei and Pentacam devices

Nicole Larivoir


10:00am Corneal thickness analysis: When is it too thin and why?

Marcony Santhiago



beyond the obvious

11:00am Epithelial map in the preoperative period of refractive surgery

Integrating Structural Tomographic Data and Epithelial Map in identifying the patient at risk

Marcony Santhiago


11:40am Artificial intelligence in diagnosing subclinical keratoconus

poojar khamar


12:00pm Percent Tissue Altered (PTA):

Concept and how to apply it in everyday life

Marcony Santhiago

12:40pm Artificial intelligence in the preoperative refractive surgery assessment 

Marcony Santhiago


12:50pm Structured thinking (Flowchart) for decision making

Marcony Santhiago


1:10pm LUNCH with lunch box and


Coordination: Lycia Pedral and Barbara Dutra

Panelists: Monica Alves, Adriana Forseto and Anderson Martins



2:00pm What's happening in the eye care market

Amaury Guerreiro


structurally speaking

2:10pm Translational biomechanics in refractive and corneal surgery

William J. Dupps

2:30pm Biomechanical principles for the refractive surgeon

William J. Dupps


2:50pm The Fragility of Knowledge

J. Bradley Randleman


3:30pm Why Q: Does asphericity manipulation work?

Marcony Santhiago


3:45pm Refractive Surgery as a turning point in the human Experience

Guy M Kezirian


4:30pm - 10:30 pm WET/DRY LABs - HANDS ON


*There will be more than 30 wet/dry labs divided into 3 time slots

4:30pm - 6:30pm

6:30pm - 8:30pm

8:30pm - 10:30pm

15 rooms during the 5 days of the course

There will also be Special Sessions with extra content.


Special Session I​I

Special session at REFRATIVA R.I.O.

4:30 pm – 8:30 pm Management: You are your business

Coordination Carla Medeiros and Carolina Angeloni

03/31/2023 Friday

we need to know more

7:30am Pupil size matters. Oh! Does it?

Glauco Mello


7:40am Optical Zone and Centralization

(Coaxial with light reflex or pupil center?)

Glauco Mello


7:50am The importance of cyclotorsion compensation

Ways to align astigmatism with different braces

Is it still necessary to mark the axes in the supine position?

Fabio Marujo


8:00am Effect of anisometropia on the predictability and accuracy of refractive surgery

Isadora de Castilhos


8:10am OCT in anterior segment

How to use this tool in the daily life of the refractive, cataract and cornea patient

Norma Allemann


Evolution and reality

8:30am "From broad beam to flying spots and such"

Evolution of the way the laser is applied to the cornea

Jackson Barreto Jr


8:45am Evolution of ablation profiles

How and why we got at the optimized profile and aspheric treatments

Jackson Barreto Jr


Therapeutic refractive surgery I

9:00am Topography-guided surgery on irregular corneas

Adriana Forseto


9:20am Excimer laser vision correction in patients with amblyopia

Julie Schallhorn


9:40am PTK: Indications and planning

Ramon Ghanem


10:00am Special Launch event for something that could change your life forever

Marcony Santhiago



enlighten me

11:00am Topography-guided LASIK on virgin corneas

Avi Wallerstein

11:20am Interpretation of higher order preoperative aberrations

Surgical manipulation of optical aberrations and their clinical effect

Jackson Barreto Jr


11:40am Ray tracing optimization of excimer laser ablation

Any room for AI?

John Kanelloupollous


Yeah... Technically that's it I

12:00pm PRK: Indications, particularities and scientific evidence | transepithelial PRK

What we know about post PRK pain

Myths and truths about haze: What is the evidence

Marcony Santhiago


​12:45pm Delayed epithelial healing after photorefractive keratectomy

Why it happens and what to do?

Julie Schallhorn

1:00pm Topical losartan as prevention of corneal haze

Lycia Pedral

1:10pm LUNCH

Yeah... Technically that's it II


2:00pm LASIK part I: Indications, particularities and scientific evidence

Marcony Santhiago


2:30pm Perspectives: Available devices for LASIK with FS and MK

Barbara Dutra


2:40pm LASIK Flap/Interface Complications and how to handle

J. Bradley Randleman


3:00pm Infectious keratitis after laser vision correction: Incidence and risk factors

Julie Schallhorn


3:10pm Deep analysis of regression rates (and their risk factors/rationality)

Michael Mimouni


3:20pm Low postoperative visual acuity: possible explanations, what to do and when?

wallace chamon


3:40pm Interview with American Academy CEO Stephen McLeod

The global refractive surgery landscape, new FDA regulations,

the future of ophthalmology with consolidations and much more


4:30pm - 10:30 pm WET/DRY LABs - HANDS ON


*There will be more than 30 wet/dry labs divided into 3 time slots

4:30pm - 6:30pm

6:30pm - 8:30pm

8:30pm - 10:30pm

15 rooms during the 5 days of the course

There will also be Special Sessions with extra content.


Special Session I​II

Special session at REFRATIVA R.I.O.

4:30 pm – 8:00 pm The OTHERS: other techniques or software available that are worth being presented in detail

Coordination Terla Castro and Isadora de Castilhos

4:30pm FLACS Femtosecond laser-assisted cataract surgery

Technique (in details), refractive outcomes, safety, and cost-effectiveness

Charles Lin


​4:50pm LAL Light Adjustable Lens

5:00pm LASEK (not LASIK) and Epi LASIK

Adriana Tytun

5:10pm LIRIC laser-induced refractive index change

Liliana Werner

5:20pm LIKE lenticule intrastromal keratoplasty

Majid Moshirfar

5:30pm FILI Femtosecond Intrastromal Lenticule Implantation

sheetal brar

5:50pm Lenticule Intrastromal Implantation for Keratoconus


6:00pm Relaxing incision: applications and nomogram

Adriana Forseto

6:10pm Femtosecond Laser–Assisted Arcuate Keratotomy

6:20pm Corneal Remodeling Technique: crescent keratectomy

Cesar Carriazo


6:30pm Bio-synthetic Collagen Presbyopic Corneal Inlay

6:40pm Pupiloplasty for visual rehabilitation

6:50pm Artificial iris: Indications and results

Ramon Ghanem

7:00pm Intrastromal ring for high myopia

Sandro Coscarelli

7:10pm Scleral lens in patient with keratoconus

Terla Castro


7:20 to 8:00pm How to use Phorcides Analytic Engine™️

Mark Lobanoff walks through this software designed to assist in planning topo-guided surgery treatments with Contoura.

01/04/2023 Saturday

In addition to the excimer laser

7:30am Anterior chamber phakic lens: results and complications

Pedro Bertino


7:45am Posterior chamber phakic lens

Perspectives: Correcting astigmatism with a phakic lens: Posterior vs anterior


8:00am Lenticle extraction: Options, technique, results and management of complications

Marcia Toledo

details matter

8:20am Limits in refractive surgery how far to steepen or flatten?

Maria Ximena Nunes


8:40am Perspectives: Differences (and similarities) between excimer laser devices

Fernando Marquez

Nomogram adjustments, centering, optical zone and tips on transposing refraction to excimer

8:50am Planning to optimize the outcome of treating astigmatism

Glauco Mello

9:00am Special features of the excimer laser for myopia

Rafael Kobayashi

9:10am Special features of the excimer laser for hyperopia 

Carla Medeiros


9:20am What Just Happened?

Complicated Complications in Refractive Surgery (medical errors)

J. Bradley Randleman

9:40 Epithelial map in postoperative monitoring

Marcony Santhiago


10:05am Myths and truths in refractive surgery

wallace chamon



11:00 Round table: Discussion of clinical situations and illustrative cases

Coordination: Marcony Santhiago and Larissa Stival

Panelists: J. Bradley Randleman, Julie Schallhorn, Wallace Chamon, Marcia Toledo, Glauco Mello, Maria Ximena Nunes and Ramon Ghanem

Dilated patient with a lot of difference in refraction, how much hyperopia to treat?

Correct static or dynamic refraction? | Astigmatism: axis of top or refraction?

Patient is not satisfied, what could it be?

The epithelium does not close, what to do?

Cataract or Cornea: Where to Go? | How to treat dry eye?

Myopic presbyopic patient, what is the best option? What if you are hypermetropic?

Altered topography and normal tomography: Can I operate?

Is this cornea too thin or can it be operated on?


Questions like these and many others in 2 hours of discussion with lightness and information


1:10pm LUNCH

2:00pm Keratoconus: Rewriting the Textbook

J. Bradley Randleman

2:30pm Keratoconus: diagnosis and natural history of the disease

Evolution criteria and management flowchart in ectatic disease

Marcony Santhiago


2:40pm All about CROSSLINKING

Beyond UV Light: The Role of Riboflavin and Its Vehicle

Correct indications, results, different situations and age

Different techniques and customization

Marcony Santhiago

3:00pm Critical review of oral riboflavin: What's the evidence?

Rafael Arantes

3:10pm Minimal thickness, techniques for thin cornea and role of oxygen

Marcony Santhiago

3:20pm CXL on thin corneas

Hyposmolar Riboflavin | Customized Sub400 protocol | contact lens assisted protocol

Marcony Santhiago

Understanding complications and unexpected results

Critical analysis of other CXL applications

Practical tips and my flowchart for doing CXL

Marcony Santhiago


​3:40pm Perspectives: The Coming Age of Pharmacological Control of the Corneal Opacity

             Topical Losartan: prophylactic and therapeutic treatments in the eye.

Steven E. Wilson


4:30pm - 10:30 pm WET/DRY LABs - HANDS ON


*There will be more than 30 wet/dry labs divided into 3 time slots

4:30pm - 6:30pm

6:30pm - 8:30pm

8:30pm - 10:30pm

15 rooms during the 5 days of the course

There will also be Special Sessions with extra content.


Special Session I​V

Special session at REFRATIVA R.I.O.

4:30 pm – 8:00 pm Do you have a cornea to operate on?

Coordination Lycia Pedral and Pedro Bertino

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4:30pm    Critical analysis: Rho Kinase (ROCK) enzyme inhibitors and surgical procedures

4:50pm    Microinvasive Glaucoma Surgery

What the anterior segment surgeon should know

5:10pm    CAIRS corneal allogenic intrastromal ring segments

5:20pm    How to use imaging tests for planning corneal transplant


5:40pm    Recovering from a penetrating transplant

5:50pm    DALK Deep anterior lamellar keratoplasty

6:00pm    Bowman Layer Transplantation

6:10pm    DMEK Descemet's Membrane Endothelial Keratoplasty DMEK

6:20pm    The endothelium and cataract surgery

What is the role of femtosecond laser cataract surgery


6:30pm    DWEK Descemetorhexis without endothelial keratoplasty

6:40pm    PDEK pre-Descemet Endothelial Keratoplasty

6:50pm    Understanding Your Patient's Central and Peripheral Image Quality


7:00 - 8:00pm     Analysis of the pharmacological treatment of myopia

Wallace Chamon


8:00 - 8:30pm     Nanotechnology and drug delivery systems for topical ocular therapy

David Smadja

02/04/2023 Sunday

7:30am    Post op. recomendations of refractive surgery and why | be patient

Claudia Morgado


Towards presbyopia

7:40am      Strategies to take the edge off presbyopia with excimer laser

Marcony Santhiago


8:10am      Comparison and correlation between biometric devices

My practical tips

Aileen Walsh

8:20am      Biometrics and calculation of the IOL after refractive surgery

The most important basic aspects and formulas

Artificial intelligence in IOL

Felipe Taguchi


8:40am      Biometrics of the patient with Keratoconus or Pelucida Marginal Degeneration

Aileen Walsh


8:50am      Critical analysis of the optical characteristics of aspherical IOLs

Newton Kara-Junior


9:00am      Toric IOL: Planning indications and results

Murilo Bertazzo


9:10am      Leftover Astigmatism: The Missing Link

Douglas Koch


9:30am      Prevention and Management of Positive and Negative Dysphotopsias

Newton Kara-Junior


9:40am      Presbyopic IOL Overview:  Current options and Future Innovations

Julie Schallhorn

10:05am    How my experience contributes to lens selection,

in identifying the ideal patient and post op satisfaction.

Armando Crema




11:00am    Corneal Topography for the Cataract Surgeon

J. Bradley Randleman


11:10am    Pharmacological treatment for presbyopia

Marguerite mcdonald


Therapeutic refractive surgery II

11:30am    Pinhole implant for irregular corneas

Bruno Trindade


11:40am    Correction of post-TX ametropias

Pedro Bertino


11:50am    Optical Evaluation of Intracorneal Ring Segment Surgery in Keratoconus:

The clinical impact

Susana Marcos

12:10pm    Overview on intrastromal corneal ring

Frederico Bicalho


12:30pm    Intrastromal corneal ring in the patient with keratoconus:

Step by step planning

Henrique Possebon


12:40pm Intrastromal corneal ring in advanced cases

Jordana Sandes


12:50pm    Modulating the cornea in patient's off target with refractive IOLs

Lycia Pedral


1:00pm    Photograph/Post Award Ceremony and closing

See you in 2024

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