To critically evaluate new evidence regarding big language models (LLMs) in cataract and refractive surgery and suggest a clinically responsible validation system. Conceptual synthesis of the recent literature of high impact and comment on a recent JCRS study on the performance of LLM compared to ophthalmology residents. Despite the high benchmark performance of LLMs, there are still severe deficits in clinical reliability, reproducibility, citation traceability, and safety in anterior-segment procedures. It proposes a three-layer validation pipeline, which includes domain-specific benchmarking, multi-dimensional performance reporting, and use-case-based deployment thresholds. It is necessary to shift the accuracy of examination to responsible clinical integration. An equity-sensitive validation framework applicable globally can make the application of AI in cataract and refractive surgery safe, transparent, and effective.
To conduct a systematic review and meta-analysis evaluating the efficacy and safety outcomes of argon laser treatment for trichiasis, a common eye condition that can lead to blindness. We conducted a systematic review and meta-analysis. PubMed, Cochrane Library, Science Direct, Embase, and ClinicalTrials.gov databases were searched for studies on argon laser treatment of trichiasis, without language restriction, up to March 2025. We computed random-effect meta-analysis and meta-regressions on putative influencing factors. The PRISMA guidelines were followed. The meta-analysis was registered on PROSPERO (ID: CRD42024546074). Twenty-seven articles were included in the systematic review, and 20 in the meta-analysis, for a total of 1044 patients. The prevalence of trichiasis recurrence at the end of follow-up was 4.1% (95% CI 2.7 to 5.5%), ranging from 0% to 37.7%, reflecting substantial heterogeneity between studies (I2 91.5%). After only one session, the prevalence of trichiasis recurrence was 35.8% (25.9 to 45.7%, I2 91.5%). The prevalence of lid complications was 0.1% (-0.2 to 0.5%). Reported complications included notching (0.1%; 95% CI, -0.2% to 0.5%), hypopigmentation (0.0%; 95% CI, -0.1% to 0.2%), and rash (0.0%; 95% CI, -0.3% to 0.3%). The prevalence of pain was 0.0% (-0.1 to 0.2%). The certainty of the evidence was assessed using the GRADE approach, and most outcomes were rated as low certainty due to limitations in study design and heterogeneity. Argon laser for trichiasis is an effective procedure, but several sessions may be necessary. The safety profile of this technique is very good with few and mild complications.
To evaluate the pooled surgical success rate, postoperative changes in intraocular pressure (IOP) and antiglaucoma medication burden following glaucoma drainage device (GDD) implantation in pediatric glaucoma, with subgroup analyses according to implant type. A systematic review and meta-analysis were conducted in accordance with PRISMA guidelines. Web of Science, PubMed, Scopus, and the Cochrane Library were searched on September 16, 2025. Eligible studies included at least 10 pediatric patients undergoing GDD implantation with a minimum follow-up of 3 months and reporting surgical success, IOP, or medication outcomes. Risk of bias in individual studies was assessed using the Newcastle-Ottawa Scale. Random-effects meta-analyses using the DerSimonian-Laird method were performed for pooled surgical success, IOP reduction, and medication reduction. Subgroup analyses were conducted for Ahmed glaucoma valve (AGV), Ahmed ClearPath (ACP), Baerveldt glaucoma implant (BGI), Aurolab aqueous drainage implant (AADI), and Paul glaucoma implant (PGI). Twenty-three studies including 1082 pediatric patients (1233 eyes) were analyzed. The overall pooled surgical success rate was 76% (95% CI, 71.1%-80.3%; I2 = 73.6%). Subgroup success rates were 70.7% for AADI, 78.9% for ACP, 73.0% for AGV, 82.3% for BGI, and 80.0% for PGI. The pooled mean IOP reduction was -16.14 mmHg (95% CI, -17.06 to -15.21; I2 = 88.3%), and the mean reduction in glaucoma medications was -1.63 (95% CI, -1.76 to -1.51; I2 = 91.4%). Meta-regression analysis demonstrated that longer follow-up duration was associated with lower surgical success and a smaller reduction in medication use, suggesting that medication requirements increased over time. GDD implantation in pediatric glaucoma is associated with meaningful IOP reduction, decreased medication burden, and an overall favorable surgical success rate across diverse pediatric glaucoma subtypes. However, substantial heterogeneity, non-uniform success definitions, and declining success with longer follow-up suggest that long-term durability may be limited, and outcomes should be interpreted cautiously, particularly in inter-device comparisons.
Antibody-drug conjugates (ADCs) are covalently conjugated molecules composed of a monoclonal antibody, a payload, and a linker. They represent an innovative therapeutic approach that combines the precise targeting capability of target therapies with the cytotoxic effects of chemotherapeutic agents. Given the unique molecular structure of ADCs, drug-related adverse reactions have drawn a considerable attention. Based on the safety data of ADCs currently available in the field of lung cancer, the common adverse drug reactions primarily involve the digestive system, hematologic system, hepatobiliary system, pulmonary system, skin, eyes, sensory nervous system, and musculoskeletal system. Unlike other cancer types, lung cancer is characterized by complex disease subtypes and molecular pathological mechanisms, as well as diverse treatment modalities. Moreover, patients with advanced lung cancer often have comorbidities such as chronic obstructive pulmonary disease and pulmonary inflammation, making the comprehensive management of ADC-related adverse reactions even more challenging. To address this, the Precision Treatment Branch of Thoracic Oncology, Chinese Geriatric Health Association, has taken the lead in organizing a multidisciplinary panel of domestic experts in gastroenterology, dermatology, respiratory medicine, ophthalmology and oncology, to discuss and jointly formulate the "Consensus of Chinese experts on the multidisciplinary management of adverse reactions to antibody-drug conjugates in the treatment of Lung Cancer (2025 edition)". A total of 21 recommendations are proposed in this consensus, covering pre-ADC safety assessments, comprehensive monitoring and management of relevant adverse reactions during ADC treatment, patient education, and medication guidance for special populations. The consensus aims is to provide clinicians with practical guidelines for the application of ADC, thereby maximizing therapeutic benefits for patients with lung cancer. 抗体药物偶联物（ADC）由单克隆抗体、有效载荷和连接子3部分共价偶联组成，是将靶向药物的精准定位与化疗药物的细胞毒性杀伤作用相结合的创新疗法。鉴于ADC独特的分子结构，其药物相关的不良反应一直备受关注。根据已披露的肺癌领域ADC安全性数据，目前常见的药物不良反应主要涉及消化系统、血液系统、肝胆系统、肺部、皮肤、眼部、外周感觉神经系统及肌肉骨骼系统等。与其他癌种不同的是，肺癌不仅疾病亚型及分子病理学机制复杂，治疗模式多样，而且晚期肺癌患者常合并慢性阻塞性肺疾病、肺部炎症等多种共患病，致使ADC相关不良反应的全程化管理更具挑战。为此，由中国老年保健协会胸部肿瘤精准治疗分会专业委员会牵头，组织国内消化科、皮肤科、呼吸科、眼科及肿瘤科等多学科专家讨论并联合制定了《抗体药物偶联物治疗肺癌不良反应多学科管理专家共识（2025版）》，共提出21条推荐意见，贯穿ADC使用前安全评估、ADC治疗期间发生相关不良反应的全面监测管理、ADC治疗的患者教育以及特殊人群的用药指导，旨在为临床医师提供切实可行的ADC应用参考准则，确保肺癌患者治疗获益最大化。.
暂无摘要（点击查看详情）
暂无摘要（点击查看详情）
Ophthalmic manifestations as the initial presentation of chronic myeloid leukemia (CML) are rare. This case describes a 38-year-old man who presented with unilateral severe vision loss alongside bilateral ocular findings, including intraretinal hemorrhages, vascular tortuosity, cotton wool spots, and optic disc edema. Ophthalmic imaging, particularly optical coherence tomography (OCT), revealed bilateral retinal involvement, which was more severe in the left eye despite worse vision in the right eye. Systemic evaluation revealed critical hyperleukocytosis, splenomegaly, and Philadelphia chromosome positivity, confirming CML. The subsequent MRI during remission showed no abnormality. Treatment with hydroxyurea and nilotinib rapidly normalized white blood cell counts and reached major molecular response (MMR) along with complete visual recovery and normal retina and optic nerve. This case highlights the importance of recognizing ocular signs as potential indicators of life-threatening systemic diseases such as CML, warranting prompt diagnosis and intervention. Ocular signs not only help to confirm the primary diagnosis, but also may serve as a useful adjunctive marker for monitoring treatment response.
Brazilin (BZ), an active isoflavonoid from Chinese herbs, exhibits antitumor properties. This study investigated its antitumor efficacy and molecular mechanisms in human glioblastoma (GBM) cells. GBM cell proliferation and viability were assessed using xCELLigence RTCA eSight™, cell counting kit-8, 5-ethynyl-2'-deoxyuridine, live/dead staining, and colony formation assays. Migration and invasion were evaluated by Transwell, three-dimensional invasion, and wound healing assays. Apoptosis was analyzed by flow cytometry, and target protein expression by western blot. A xenograft model was established by subcutaneous injection of P3 cells into nude mice, followed by BZ treatment at different concentrations. BZ significantly inhibited GBM cell proliferation and viability in time- and dose-dependent manners. It also suppressed cell invasion and migration dose-dependently. Apoptosis rates in U251, P3, and LN229 cells increased significantly after BZ treatment. Accordingly, BZ upregulated the apoptosis-related proteins B-cell lymphoma 2 (BCL-2)-associated X protein and cleaved poly (ADP-ribose) polymerase-1, as well as the autophagy-related protein LC3B, while downregulating BCL-2 and sequestosome 1. Phosphorylated phosphoinositide 3-kinase (PI3K), protein kinase B (AKT), and mammalian target of rapamycin (mTOR) levels were reduced in BZ-treated U251 and LN229 cells. Finally, BZ inhibited the growth of orthotopic xenografts from luciferase-expressing P3 cells in mice. BZ induces apoptosis and autophagy in GBM cells via the PI3K/AKT/mTOR signaling pathway, suggesting its potential as a novel therapeutic agent for GBM patients.
Diabetic retinopathy (DR) is a major cause of irreversible vision loss driven primarily by retinal vascular damage, yet its mechanisms remain incompletely understood. Here, we identify calnexin (Canx) as a critical suppressor of pathological angiogenesis in DR. We demonstrate that hyperglycemia synergizes with TNF-α to downregulate Canx in mouse retinal microvascular endothelial cells. This loss of Canx activates Nox4, leading to hyperactivation of the Ire1α/Xbp1s branch of the unfolded protein response. Consequently, endoplasmic reticulum stress is amplified, pathological Vegfa transcription is upregulated, and the inner blood-retinal barrier is disrupted. In streptozotocin-induced diabetic mouse models, Canx deficiency exacerbated endothelial dysfunction and retinal vascular pathology. Conversely, both adalimumab treatment and adeno-associated virus-mediated Canx overexpression in vivo suppressed the Nox4/Ire1α/Xbp1s/Vegfa cascade, significantly reduced vascular leakage and acellular capillary formation, attenuated retinal thinning, and normalized endothelial cell functions (proliferation, migration, tube formation). Collectively, our findings establish Canx as a key upstream regulator of Vegfa-mediated vascular injury in DR. Our study suggests that targeting Canx, either genetically or via repurposing adalimumab, represents a source-specific strategy to halt DR progression by blocking pathological Vegfa production at its origin. Diabetic retinopathy (DR) remains a leading cause of blindness, with current interventions often failing to halt progression. In mouse retinal microvascular endothelial cells (mRMVECs), hyperglycemia/tumor necrosis factor-α suppress calnexin (Canx). Canx downregulation drove vascular pathology in mRMVECs via the Nox4/Ire1α/Xbp1s pathway, amplifying endoplasmic reticulum stress and pathological Vegfa production. In streptozotocin-induced diabetic mouse models, Canx overexpression or adalimumab intervention attenuated DR in vivo by blocking this cascade. Our findings establish Canx as a critical upstream regulator, proposing Canx-targeted strategies as source-specific therapeutics for DR.
To investigate the incidence, characteristic manifestations, outcomes of changes, and potential clinical significance of the foveal vertical hyperreflective line (FVHL) on optical coherence tomography angiography (OCTA) in patients with macular neovascularisation (MNV). This retrospective observational case series was conducted using OCTA images, fundus photographs, best-corrected visual acuity measurements, and other clinical information of the eyes of patients with MNV who were followed up for at least 3 months between January 2024 and October 2025. The incidence of FVHLs, OCTA characteristics, FVHL changes, and prognoses were analysed. Among the 322 eyes of 161 patients with MNV, 14 patients (8.7%) showed FVHLs in 15 eyes. The mean age of the patients was 69.29 ± 12.68 years. Among the eyes with an FVHL, 13 were of patients with age-related macular degeneration-MNV and two were of patients with pathological myopia-MNV. All cases showing FVHLs occurred in the early stages of the disease course (within 1-3 months) and did not disappear during follow-up. Among the cases with FVHLs, 80% showed no obvious changes in the FVHLs and 20% showed weakened reflexes. The eyes that showed FVHL maintenance had a higher interdigitation zone/ellipsoid zone (IZ/EZ) repair rate (91.7%) than those with reflex-weakened FVHLs (p = 0.009). FVHLs were present in 8.7% of patients with MNV. The eyes that maintained FVHLs exhibited a higher degree of IZ/EZ restoration than the eyes with reflex-weakened FVHLs. This OCTA finding may provide a foundation for assessing the recovery responses of retinal photoreceptors and Müller cells.
Chronic ocular graft-versus-host disease (coGVHD) after allogeneic hematopoietic stem cell transplantation (allo-HSCT) may lead to irreversible ocular surface damage and even vision loss. Current management of coGVHD faces challenges, with frequent missed or misdiagnosed cases. This study aimed to leverage a multimodal large language model (MLLM) to develop an early warning and diagnostic system for coGVHD. A total of 666 post-allo-HSCT patients (early warning model) and 805 post-allo-HSCT patients (1574 eyes, diagnostic model) were enrolled for construction, internal validation, and external validation of the corresponding models. We proposed the GVHD-MLLM, a multitask multimodal network that fused latent representations from four modal sequences to provide high-precision, real-time predictions for two tasks. The GVHD-MLLM achieved high performance in internal testing, with AUROCs of 93.44% (95% CI: 91.85-95.03%) for early warning, 98.98% (95% CI: 98.59-99.36%) for diagnosis, and 98.24% (95% CI: 98.05-98.43%) for disease severity grading. In external validation, the early warning AUROC was 83.45%, while diagnostic AUROCs across three external sites were all above 96.0%. The disease severity of patients seeking medical treatment after using the early warning model was significantly lower. Junior ophthalmologists also improved diagnostic accuracy using the model as an auxiliary tool. The GVHD-MLLM can process rich multi-modal information collected in clinical practice, and is expected to become an effective tool for managing coGVHD.
The aim of this study was to compare long-term effect of phacoemulsification combined with goniosynechialysis (Phaco-GSL) in patients with acute primary angle-closure glaucoma (APACG) and those with chronic primary angle-closure glaucoma (CPACG), and to evaluate the influencing factors of the surgical prognosis. In this prospective cohort study, patients with APACG or CPACG who underwent Phaco-GSL at the glaucoma clinics of Eye and ear, nose, and throat (ENT) Hospital were recruited consecutively from January 2019 to December 2022. Standardized 2-year follow-ups assessed baseline characteristics and surgical outcomes. The cumulative success rates and influencing factors of surgical prognosis were analyzed. A total of 213 patients were enrolled, including 116 patients (116 eyes) with APACG and 97 patients (97 eyes) with CPACG. The average age was 64.5 ± 7.2 years and 153 (71.8%) patients were women. The complete success rates at 2 years were 72.4% in the acute group and 65.0% in the chronic group (P = 0.04). The qualified success rates at 2 years were 81.9% in the acute group and 81.4% in the chronic group (P = 0.44). Baseline mean deviation, anterior chamber depth (ACD), and glaucoma type were identified as independent predictors of surgical outcomes in the overall cohort. In subgroup analyses, a longer duration of elevated intraocular pressure showed a trend toward poorer surgical prognosis in acute PACG, whereas shallower ACD was associated with poorer outcomes in chronic PACG. Phaco-GSL demonstrated significant benefits for both APACG and CPACG, with more pronounced effects for APACG. Identifying patients with prognostic factors preoperatively provides valuable insights for better assessing the outcomes of GSL surgery in PACG.
Identifying individuals at high risk of axial elongation is crucial for managing adults with high myopia, as further elongation substantially increases the risk of vision-threatening complications. This study aimed to identify the optimal predictors for axial elongation in this population. This prospective cohort study enrolled 1025 eyes from 532 adults with high myopia (18-60 years). We evaluated the predictive performance of nine candidate variables for rapid axial elongation, defined as a 2-year axial elongation of at least 0.10 mm. Predictors were selected using bidirectional stepwise regression. Model discrimination was assessed using the area under the receiver operating characteristic curve (AUC), and the incremental value of the new model was quantified using integrated discrimination improvement (IDI). The mean annual axial elongation rate was 0.020 ± 0.051 mm/year, and 24.78% of eyes developed rapid axial elongation. Stepwise regression constructed a full model (AUC = 0.811) including six predictors-age, sex, axial length, best-corrected visual acuity, choroidal thickness (ChT), and vascularity index. ChT showed the highest individual discriminative ability (AUC = 0.728), followed by age (AUC = 0.666). Removing age or ChT from the full model reduced the AUCs to 0.735 and 0.753, respectively (both P < 0.001), with IDIs of  - 0.116 and - 0.095 (both P < 0.001). In contrast, excluding sex only resulted in an IDI of - 0.008 (P = 0.032). Simplified models combining age and ChT, with or without sex, showed discrimination comparable to that of the full model, with only modest reductions in predictive performance (IDIs: -  0.028 and - 0.033, respectively; both P < 0.05). In the bivariate model, the predictive cut-off of ChT decreased progressively with age, ranging from 187 µm at age 20 to 29 µm at age 60. The results remained consistent in sensitivity analyses using alternative axial elongation definitions (0.05 mm and 0.15 mm). Nonlinear relationship analyses revealed that thinner choroids were associated with faster axial elongation rate only below an inflection point. ChT and age are the optimal predictors for axial elongation in adults with high myopia. These findings establish their dominant role in personalized management and support further investigation into choroidal architecture to guide proactive, choroid-centered strategies. This study was registered with the Chinese Clinical Trial Registry (ChiCTR2100047424).
Activation of endothelial Tie2 signaling has emerged as a potential therapeutic strategy for ameliorating vascular abnormalities and hyperpermeability in ocular diseases. Early therapeutic strategies have focused on inhibiting angiopoietin-2 (Ang2), an antagonistic ligand of Tie2, thereby indirectly promoting Tie2 activation. However, accumulating evidence indicates that indirect Tie2 activation via Ang2 blockade is insufficient for enhanced therapeutic efficacy, underscoring the need for Tie2 agonists. In addition, since it is still necessary to inhibit neovascularization induced by vascular endothelial growth factor (VEGF), appropriate therapeutic efficacy could be achieved by direct Tie2 agonism and VEGF neutralization. An affinity-matured Tie2-activating antibody, MT-101, was identified by phage display panning using a complementarity-determining region-targeted mutagenesis library. Tie2xVEGF bispecific antibodies were generated with MT-101 fused to five different anti-VEGF modules, and their functionality in Tie2 and VEGF signaling was compared using endothelial cells. The therapeutic efficacy of the bispecific antibody fusion MT-103, comprising MT-101 and VEGFR domains, was evaluated in mouse oxygen-induced retinopathy (OIR) and laser-induced choroidal neovascularization (LI-CNV) models compared with anti-VEGF agent Aflibercept or Ang2xVEGF bispecific antibody. MT-101 activated the Tie2 signaling pathway, including AKT-eNOS and ERK cascades, and exhibited efficacy comparable to that of Aflibercept in OIR and LI-CNV models. By directly comparing five different Tie2xVEGF bispecifics, we selected the most potent construct, MT-103, generated by fusing VEGFR1/2 domains to MT-101. MT-103 demonstrated approximately four- and five-fold greater potency than the Ang2xVEGF bispecific antibody in inhibiting VEGF signaling and reducing permeability, respectively, in retinal endothelial cells. MT-103 further demonstrated improved efficacy, reducing neovascularization by 14% compared with Aflibercept in the LI-CNV model and suppressing vascular leakage by 20% compared with Ang2xVEGF bispecific antibody in the OIR model. Moreover, MT-103 elicited robust Tie2 activation and vessel stabilization by enhancing pericyte coverage relative to Ang2xVEGF bispecific antibody. These findings demonstrate that a therapeutic strategy combining direct Tie2 activation and VEGF blockade may provide improved therapeutic potential compared to neutralizing VEGF alone or Ang2 and VEGF, representing a promising therapeutic strategy that warrants further validation for the treatment of various ocular diseases.
Social determinants of health (SDOH) may improve Alzheimer's disease (AD) risk prediction by capturing upstream contextual risk beyond routinely measured clinical variables. We aimed to develop and validate an accurate, interpretable machine-learning pipeline for AD risk prediction in UK Biobank using routinely collected data. Using data from 13 076 participants in the UK Biobank, we developed an automated machine-learning pipeline for AD risk prediction with feature selection and a C5.0 boosted-tree classifier. Data were split into training, development and test sets (7:2:1); missing values were imputed in the training data only, and feature selection, tuning and threshold calibration were performed using the training/development data, with final evaluation on the independent test set. Internal validation used repeated subsampling without replacement. During up to 16 years of follow-up, 927 participants developed AD. Feature selection reduced 3590 variables to 26 predictors spanning age, APOE4, SDOH, medical history and routine clinical measures. The final model showed good discrimination (area under the precision-recall curve 0.89) and adequate calibration (Hosmer-Lemeshow p=0.71), with stable performance under repeated subsampling. Sex-stratified models showed similar patterns. SDOH contributed useful predictive information, but their associations should be interpreted as predictive rather than causal and may reflect socioeconomic confounding and healthcare access. This model could support scalable AD risk screening using routinely collected data, but external validation and recalibration in non-UK populations are needed before broader application.
Optic nerve injury induces rapid retinal neurodegeneration; however, how distinct retinal cell type responses are coordinated from the hyperacute injury phase to the early repair phase remains incompletely understood. In this study, to explore the dynamic changes in intercellular and intracellular signaling events between different cell types and elucidate their potential roles in retinal ganglion cell survival and early repair, we generated a time-resolved single-nucleus RNA sequencing atlas of adult male mouse retinas across five hyperacute-to-acute timepoints (2 hours, 8 hours, 1 day, 3 days, and 7 days) following optic nerve injury. Using computational network analysis, we reconstructed dynamic cell-to-cell communication and subsequent internal genetic responses among retinal ganglion cells, Müller glia, microglia, and endothelial cells. Distinct stage-specific intercellular communication networks were identified, including transient Itgb1-associated signaling between Müller glia and retinal ganglion cells that peaked at early timepoints, enhanced Nrxn1-Nlgn1-mediated signaling in endothelial cells during the acute phase, and sustained Sema6a-Plxna4 interactions in microglia through day 7. Functional pathway analysis linked these signaling events to focal adhesion, energy metabolism, immune regulation, and cell adhesion pathways. Multiplex immunofluorescence further validated the temporal dynamics and spatial localization of key signaling molecules, including Itgb1, Nlgn1, and Plxna4, consistent with the transcriptomic findings. Collectively, these results delineate a coordinated hyperacute-to-acute neuro-glial-vascular signaling network that supports retinal ganglion cell survival and identify potential molecular targets for therapeutic intervention following optic nerve injury.
Dry eye disease (DED) is a common ocular disorder that severely impairs daily life. Oxidative stress has been identified as a key pathogenic factor driving cellular senescence and corneal epithelial damage in DED. Herein, we developed a biocompatible supramolecular complex based on the host-guest interaction of TEMPO-modified β-cyclodextrin (TCD) and puerarin (Pue), designated as P@TCD, for managing DED. The P@TCD could mitigate the ROS accumulation, reduce DNA damage, promote cell cycle progression, and attenuate cellular senescence in the corneal epithelium, thus preventing the further deterioration of DED. In two DED mouse models, P@TCD demonstrated favorable therapeutic efficacy by reversing corneal epithelial defects, alleviating conjunctival damage, and accelerating lacrimal gland recovery, thereby restoring tear film homeostasis, especially improving tear film stability with TBUT values of more than 5.3 s, compared to the DED models of less than 2.8 s, which is even more than the Cycloome® of 3.7 s. These results suggested the considerable potential of this dual ROS scavenging strategy for the effective treatment of DED.
Digital technologies, such as artificial intelligence (AI), virtual reality (VR), and haptic simulation, are rapidly reshaping oral health education. Traditional phantom head and clinic-based teaching remain essential but no longer suffice alone for digital-native learners or for regulators who increasingly view digital competence as mandatory. Post-COVID evidence suggests immersive and hybrid approaches can enhance motivation, deepen learning, support well-being, and strengthen clinical competence when thoughtfully embedded into curricula. Done well, this integration can foster safer, patient-centered digital care. Sustainability concerns around traditional, resource-intensive methods are also growing; digital tools can reduce material waste and resource use, aligning dental education with the United Nations 2030 Agenda for Sustainable Development. However, access to these innovations is uneven, raising concerns about a digital divide in graduate readiness and patient care. Networks such as the American Dental Education Association (ADEA), the Association for Dental Education in Europe (ADEE), the Haptic and AI Digital Education Network for Excellence and Research (HAiDENERS) show how collaboration and benchmarking can democratize advanced simulation. Together with active communication involving global research bodies and industry, these developments enable a hybrid, evidence-informed, and equitable training ecosystem whose ultimate goal is improved, safer, and more predictable oral health care worldwide.