- Ab Interno Lateral Wall Decompression: A Surgical Innovation That Stood the Test of Time
Effect of surgical correction of exopthalmos and upper lid retraction in patient with Graves’ orbitopathy (with permission of patient) In 2000, we published a new surgical approach for orbital decompression in patients with Graves’ orbitopathy: Ab Interno Lateral Wall Decompression. More than two decades later, it is gratifying to see that this technique continues to be used by orbital surgeons worldwide and remains a valuable option in the surgical management of thyroid eye disease.
The concept behind Ab Interno Lateral Wall Decompression was straightforward: achieve effective proptosis reduction while minimizing surgical morbidity and maximizing cosmetic outcomes. By approaching the lateral orbital wall from within the orbit, the technique offers several important advantages. It results in minimal visible scarring, provides favorable proptosis reduction with a low risk of inducing diplopia, and avoids disruption of the temporalis muscle, thereby preventing temporalis atrophy and the associated functional and cosmetic concerns.
An additional advantage is the versatility of the approach. Ab Interno Lateral Wall Decompression can be readily combined with decompression of the medial wall and orbital floor when greater reduction of proptosis is required. Through a swinging eyelid approach and/or a transcaruncular approach, surgeons can access multiple orbital walls while maintaining excellent exposure and avoiding external facial incisions. This flexibility allows the procedure to be tailored to the severity and pattern of disease, ranging from isolated lateral wall decompression to balanced multi-wall decompression.
Figure from ESOPRS Book vol 2 (Springer 2024, Eds: Quaranta-Leoni F, Verity D, Paridaens D); (illustrations by Jessica Leenen) The enduring popularity of Ab Interno Lateral Wall Decompression reflects the importance of balancing surgical efficacy with patient-centered outcomes. While reducing proptosis is a primary objective, preserving ocular motility, minimizing complications, and optimizing cosmetic results are equally important considerations for both patients and surgeons.
What makes me particularly proud is not only the procedure itself, but also the environment in which it was developed. At Het Oogziekenhuis Rotterdam, in close collaboration with Erasmus MC, research into the pathophysiology and treatment of Graves’ orbitopathy has been a major focus for decades. The combination of clinical excellence, scientific inquiry, and multidisciplinary collaboration provided the foundation for developing and refining innovative surgical approaches such as Ab Interno Lateral Wall Decompression.
Looking back, it is rewarding to know that a technique developed in Rotterdam continues to benefit patients more than 25 years after its introduction. Surgical innovations rarely succeed because of technical ingenuity alone; they endure because they improve outcomes and quality of life for patients. The continued use of Ab Interno Lateral Wall Decompression is a testament to the dedication of colleagues, mentors, researchers, trainees, and patients who contributed to its development and evaluation over the years.
As our understanding of Graves’ orbitopathy continues to evolve, and as new treatments emerge, it is worth reflecting on how meaningful advances are achieved: through the integration of clinical care, research, and a commitment to improving the lives of our patients.
Reference
Paridaens DA, Verhoeff K, Bouwens D, Van den Bosch WA. Transconjunctival orbital decompression in Graves’ ophthalmopathy: lateral wall approach ab interno. British Journal of Ophthalmology. 2000;84(7):775–781.
#GravesOrbitopathy #ThyroidEyeDisease #OrbitalSurgery #AbInternoLateralWallDecompression #Oculoplastics #OrbitalDecompression #MedicalInnovation #ErasmusMC #OogziekenhuisRotterdam #PatientCare
- Dion Paridaens at International Orbital Society Meeting 2026: Science, Debate and Friendship in Amsterdam
On 21 and 22 May 2026, the International Orbital Society Meeting took place at the beautiful Hotel Arena in Amsterdam, excellently organized by Prof. Peerooz Saeed.
The meeting was held in The Chapel, the showpiece of Hotel Arena and the former chapel of the Catholic orphanage built in 1886. It was a truly unique and inspiring setting for two days of scientific exchange, discussion and friendship.
The International Orbital Society (IOS) is a highly selective, by-invitation professional society with a limited international membership, dedicated to advancing orbital surgery and orbitology. It brings together leading surgeons and researchers in ophthalmology, oculoplastic surgery and facial plastic surgery.
I was honoured to present what we believe to be the first case of successful primary stereotactic radiotherapy for a biopsy-proven solitary fibrous tumour of the orbit. In this patient, surgery would have carried a high risk of serious functional complications, including possible loss of vision in her best eye.
It was also a privilege to moderate a session with lively debates on a wide range of orbital topics. One particularly fascinating contribution came from Prof. Eric Schliesser, who gave a historical perspective on the philosopher Baruch Spinoza, born in Amsterdam in 1632 and of Portuguese-Jewish origin.
Most of all, it was wonderful to reconnect with friends and colleagues from around the world, including a special reunion with my ESOPRS friends Francesco Quaranta Leoni and David Verity.
Grateful for the inspiring discussions, warm collegiality and continued exchange within this remarkable international community.
Full and Advisory Members of the International Orbital Society gethering in Amsterdam 
My ESOPRS friends David Verity (right) and Francesco Quaranta-Leoni (middle) reuniting at the Orbital Society Meeting 2026 - Paridaens Opponent at PhD Ceremony in Helsinki
Honoured to serve as the official Opponent from the Netherlands at the PhD defense of Dr Paula Niinimäki at the University of Helsinki on 15 May 2026.
In the traditional Finnish doctoral defense system, there is typically a single external examiner — the “Opponent” — who conducts the public scientific examination of the candidate. During this defense, Dr Niinimäki was questioned for approximately 90 minutes on the scientific content, methodology, clinical implications, and future perspectives of her dissertation:
Periorbital and Orbital Malignant Tumours: What Lies Beneath.
Professor Tero Kivela served as Kustos during the ceremony. The Kustos is the chair and guardian of the defense proceedings — traditionally supervising the academic protocol and formally overseeing the public examination. It was a pleasure to reconnect with Professor Kivela and colleagues in Helsinki. He remains one of Europe’s leading mentors and teachers in ophthalmic oncology, and the high scientific quality of this dissertation clearly reflected that academic environment.
Dr Marita Uusitalo also played a prominent role throughout the academic trajectory leading to this dissertation. As Chair of the Oculoplastic Department and an important mentor to Dr Niinimäki, her influence was clearly visible in the strong clinical and surgical foundation underlying this work.
One of the striking aspects of the thesis was the clear multidisciplinary collaboration involved in the management of these complex periocular and orbital malignancies, including close cooperation between ophthalmology, ENT surgery, plastic surgery, pathology, oncology, and radiology. This collaborative spirit was also reflected socially: the number of colleagues and friends attending both the defense ceremony and the festive evening afterwards was truly overwhelming and clearly demonstrated the respect and appreciation surrounding Dr Niinimäki and her team.
The thesis addressed several important topics within ophthalmic oncology, including delayed diagnosis of periocular malignancies, sebaceous carcinoma, perineural invasion, orbital exenteration, and the multidisciplinary management of advanced orbital disease.
Dr Niinimäki demonstrated broad knowledge of the field, critical scientific thinking, and mature clinical judgment throughout the examination.
Congratulations to Dr Paula Niinimäki on an excellent defense and on obtaining the degree of Doctor of Medical Sciences.
- Eyelid Surgery is not Cosmetic Surgery
- Dion Paridaens Visiting Professor Hôpital Fondation de Rothschild in Paris
I’m pleased to share that on February 26th, I formally started an invited Professorship at the historic l’Hôpital Fondation de Rothschild in Paris.
I received a very warm welcome from the Head of Ophthalmology, Dr. Olivier Galatoire — a well-known colleague in the field — and Dr. Marie Callet, research leader of the department.
During my visit, I gave a presentation highlighting the importance of multidisciplinary collaboration in orbital disease, as well as the challenges that arise when such collaboration is not optimally structured.
In this role, I will frequently provide lectures for the medical staff and support the research activities of this prestigious institute. Founded in 1905 by Baroness Julie-Caroline de Rothschild, in accordance with the wishes of her late husband Baron Adolphe de Rothschild, the institution has a remarkable legacy in advancing medical care and research.
I look forward to contributing to education, collaboration, and innovation in this inspiring environment.
L’ Hôpital Fondation de Rothschild in Paris (dating from 1905) 
Staff of l’Hôpital Fondation de Rothschild in Paris 
Dr Olivier Galatoire, Head of Ophthalmology Service in l’Hôpital de Rothschild in Paris (left) - Dr Dion Paridaens Invited Lecturer in Vietnam
Honored to join the inaugural VSOPRS meeting in Hanoi, January 9–10, 2026, as a moderator and invited speaker within the APSOPRS–VSOPRS scientific program. I presented on “Management of Upper Eyelid Retraction in Thyroid Orbitopathy,” sharing practical decision pathways and surgical pearls to improve functional and aesthetic outcomes.
My sincere thanks to the VSOPRS leadership, organizers, and all colleagues—national and international—whose contributions elevated the meeting. As Immediate Past President of ESOPRS, I look forward to building meaningful collaborations between VSOPRS and ESOPRS across education, research, and clinical practice. 🤝🇻🇳
- Still inspired after an unforgettable ESOPRS 2025 Meeting in Prague!
From 11–13 September, the 43rd Annual Meeting of the European Society of Ophthalmic Plastic and Reconstructive Surgery (ESOPRS) brought together colleagues from around the world in the magnificent Municipal House. The Art Nouveau venue, dramatic organ music at the opening ceremony, and a world-class scientific program set the stage for three inspiring days.
It was a great honour to serve as President during this meeting. Highlights for me included:
🎤 Delivering an invited lecture on “The Great Mimic: Diagnostic Pitfalls in Benign and Malignant Lacrimal Gland Tumours” at the Pre-meeting Course Day (11.9.2025).
🎤 Introducing the 2025 Mustardé Lecturer, Prof. Peerooz Saeed, who gave a powerful talk on “The Optic Nerve, a Story of Survival.”
🏆 Presenting the ESOPRS Junior Award to the promising researcher Anne Xuan-Lan Nguyen.
🌍 The sessions covered everything from eyelid, lacrimal, and orbital surgery to cutting-edge advances in AI, endoscopic orbital approaches, and trauma management in times of conflict.
Social highlights were equally memorable:
📸 A welcome reception on a floating restaurant near Mánes Bridge, with stunning views of Prague Castle and Charles Bridge.
📸 A breathtaking gala dinner at the magnificent Žofín Palace, on an island in the River Moldau.
At the close of the meeting, I had the privilege of handing over the President’s chain to my good friend Miguel Gonzalez Candial from Barcelona. I now look forward to continuing to serve the Society for another two years on the Council as Immediate Past-President.
A heartfelt thank you to the local organizing committee, especially Dr. Vladimír Krátký and Dr. Adam Kopecký, for their tireless efforts. I leave Prague inspired, grateful, and proud — and already excited for what lies ahead!
Dion Paridaens
Meeting with African Society colleagues 
Chairing a session with Prof G Rose 
Introducing the Mustarde Lecturer Prof Saeed - 🌟 Reflections on the APSOPRS–ESOPRS Joint Symposium at SOE 2025
📍 Lisbon | 🗓️ Monday, June 9, 2025
We were thrilled to close SOE 2025 on a high note with a well-attended joint symposium between the Asia-Pacific Society of Ophthalmic Plastic and Reconstructive Surgery (APSOPRS) and the European Society of Ophthalmic Plastic and Reconstructive Surgery (ESOPRS).
The session focused on key updates in Oculofacial Rejuvenation & Blepharoptosis Surgery, with engaging talks and lively discussion throughout.
💡 Program Highlights:
- Lower lid & midface rejuvenation – Dan Georgescu (via video)
- Indirect brow lifting & brow pexy – Nguyen Thi Thu Hien
- Botulinum toxin & fillers – Kasturi Bhattacharjee
- Congenital blepharoptosis (anterior levator resection) – Dion Paridaens
- Acquired blepharoptosis (external technique) – Francesco Quaranta-Leoni
- Acquired blepharoptosis (internal technique) – Akshay Nair
🎤 Moderated by:
Kasturi Bhattacharjee (APSOPRS President)
Dion Paridaens (ESOPRS President)
📸 Grateful for the kind invitation by the SOE Scientific Committee (Christoph Hintschich) to organize this joint symposium.
Grateful for the collegial spirit and contributions of our panelists and attendees. Thank you for making this session a meaningful conclusion to SOE 2025!
#SOE2025 #APSOPRS #ESOPRS #Oculoplastics #FacialRejuvenation #Blepharoptosis #Ophthalmology #MedicalEducation #AestheticSurgery #GlobalEyeCare #RotterdamEyeHospital #ErasmusMC #ELZAinstitute
- ASOPRS–ESOPRS Joint Symposium at SOE 2025
🔍 Oculoplastics: Pearls, Tricks and Tips
📍 Lisbon, Portugal | 🗓️ Sunday, June 8, 2025 | 🕒 16:30–18:00
We were honored to present a well-attended and highly engaging joint symposium between the American Society of Ophthalmic Plastic and Reconstructive Surgery (ASOPRS) and the European Society of Ophthalmic Plastic and Reconstructive Surgery (ESOPRS) at SOE 2025.
Moderated by Ken Morgenstern, MD (Past President, ASOPRS) and Dion Paridaens, MD PhD (President, ESOPRS), the session focused on practical pearls and surgical strategies in oculoplastic reconstruction, eyelid malposition, and periocular pathology.
💡 Program Highlights:
- Trauma of the Lacrimal System – Reza Vagefi (USA)
- Entropion/Ectropion Repair: Pearls and Tips – Elin Bohman (Sweden)
- Pitfalls of Upper Blepharoplasty – Peter Timoney (USA)
- Eyelid Lumps and Bumps – Dan Georgescu (Romania) (via video)
- Challenges of Upper Lid Lengthening – Ted Wladis (USA)
- Spotlight on Eyelid Reconstruction – Dion Paridaens (Netherlands)
🙏 We are especially grateful to the SOE 2025 Scientific Committee for the kind invitation to organize this joint oculoplastic symposium, and to all attendees for contributing to its success.
#SOE2025 #ASOPRS #ESOPRS #Oculoplastics #LacrimalSurgery #EyelidReconstruction #Blepharoplasty #Ophthalmology #MedicalEducation #GlobalEyeCare #SurgicalTraining #CollaborationInMedicine #RotterdamEyeHospital #ErasmusMC #ELZAinstitute
- Oculoplastic & Orbital Session at Annual Meeting of Dutch Ophthalmology Society (N.O.G.)
📍 Annual Meeting of the Dutch Ophthalmology Society (N.O.G.) – Maastricht, April 2–4, 2025
👁️ Oculoplastic & Orbital Session – Thursday, April 3
It was a pleasure to attend and contribute to the Dutch Orbital Society (DOS) session during the NOG 2025 conference. The afternoon featured a range of insightful lectures by Dutch oculoplastic and orbital surgeons, highlighting recent research and clinical advancements.
We were especially honored to welcome our international guest speaker, Dr. Marco Sales-Sanz from Madrid, Spain. His lecture on new developments in the management of Graves’ orbitopathy was both enlightening and practical.
The session was rounded off by excellent educational presentations by three members of the DOS Advisory Board, sparking valuable discussions and knowledge exchange.
A big thank you to everyone who made this session a success!
#NOG2025 #DutchOphthalmology #Oculoplastics #OrbitalSurgery #MedicalEducation #GravesOrbitopathy #Collaboration #KnowledgeSharing
Guest speaker Dr Marco Sales-Sanz (center), Prof Peerooz Saaed (left), Dr Dion Paridaens (right)
