2008 memoria

Càtedra de Recerca en Oftalmologia "Joaquim Barraquer" - UAB

MEMÒRIA ANUAL Exercici 2008

Càtedra de Recerca en Oftalmologia "Joaquim Barraquer" - UAB

PRESENTACIÓN.......................................................................................... 3 1.

LÍNEAS DE INVESTIGACIÓN EN DESARROLLO ..........................4 1.1 Proyecto Phaco Ersatz ......................................................................................... 4 1.1.1 Aparato para simular la acomodación ex vivo ................................................................. 4 1.2 Calidad óptica del ojo........................................................................................... 6 1.2.1 Medición de la calidad de visión en pacientes post LASIK........................................... 6 1.2.2 Cuantificación de la luz dispersa en pacientes capsulotomía YAG .............................. 8 1.3 Queratoprótesis y cultivo de células limbares ..................................................... 9 1.3.1 Resultados a largo plazo de osteo - osteoodonto - queratoprótesis ............................. 9 1.3.2 Proyecto Europeo: Córnea artificial ................................................................................ 10 1.3.3 Cultivo de células limbares................................................................................................ 11 1.4 Enfermedades congénitas...................................................................................13 1.4.1 Catarata congénita.............................................................................................................. 13 1.4.2 Aniridia congénita .............................................................................................................. 15

2. ACTIVIDADES DOCENTES ............................................................... 17 2.1 Tesis de doctorado en desarrollo ........................................................................17 2.2 Trabajos de investigación Máster .......................................................................18 2.3 Actividades en organizaciones nacionales e internacionales ............................ 22 2.3.1 European Association for Vision and Eye Research.................................................... 22 2.3.2 Acta Ophthalmologica....................................................................................................... 23 2.3.3 European Vision Institute - Clincal Trials...................................................................... 24 2.3.4 Redes Temáticas de Investigación Cooperativa............................................................. 28 2.4 Formación y cursos .............................................................................................31 2.4.1 Transparency Club Meetings ............................................................................................ 31

3. PUBLICACIONES ................................................................................32 3.1 3.2 3.3

Publicaciones en revistas ................................................................................... 32 Publicaciones de libros y capítulos de libros..................................................... 32 Presentaciones en congresos internacionales.................................................... 32

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Càtedra de Recerca en Oftalmologia "Joaquim Barraquer" - UAB

Presentació Amb la normalitat que donen els anys de treball continuat, podem presentar la memòria d'activitats del 2008 parlant, en primer lloc, del nostre ingrés l'any 2007 a la xarxa europea d'assajos clínics del "European Vision Institute", integrada per diversos centres d'excel·lència europeus en investigació oftalmològica. Aquesta institució es dedica a la realització de recerca clínica multicèntrica en oftalmologia, que exigeix uns nivells de qualitat molt elevats, per la qual cosa es fa necessari complir tota la normativa europea i internacional. La certificació oficial com a membre de la xarxa va ser obtinguda al mes d’abril de 2008.

La línia de recerca sobre presbícia i cataracta ens permet combinar la investigació bàsica i la clínica. En un estudi de morfologia, realitzat recentment conjuntament amb el Netherlands Ophthalmic Research Institute, hem establert una relació entre les forces del múscul responsable de l'acomodació i el desenvolupament de la cataracta cortical. Aquest estudi està lligat al nostre projecte clínic "Phaco Ersatz", que es centra en la recuperació de l'acomodació després de la cirurgia de cataracta. També hem millorat l'aparell de simulació de l'acomodació solventant així el problema de la fixació del conjunt cristal·lí-múscul ciliar dins de l’aparell.

En la recerca per guarir les malaties greus de la superfície ocular, un altre exemple en què es combina la recerca bàsica i la clínica, estem treballant en quatre línies. En la primera hem publicat els resultats a llarg termini de osteo- i osteoodonto-queratopròtesi, on el Centre d’ Oftalmologia Barraquer té una experiència de més de 30 anys. La segona és la queratopròtesi de "Boston", on ja tenim certa experiència i estem en la fase d'avaluació dels primers resultats clínics. Una nova línia és un projecte de la UE sobre un nou tipus de queratopròtesi. En aquest cas la novetat és el tractament específic de la superfície de la pròtesi per a una millor integració en la còrnia receptora. I finalment, hem iniciat una cooperació amb l'Hospital Universitari d'Oslo sobre el trasplantament de cèl·lules epitelials, cultivades ex vivo a la superfície cornial. És una nova estratègia terapèutica que consisteix en tractar la deficiència de cèl·lules mare limbars, que causa moltes malalties greus en la superfície ocular. El nostre objectiu és preparar cultius d'explants limbars en el nostre propi laboratori de cultiu cel·lular. Enguany hem decidit donar un nou impuls a les possibilitats de les nostres instal·lacions per assolir tasques de recerca més complexes, amb l'adequació d'una sala blanca qu en s permeti desenvolupar projectes de cultiu cel·lular.

Dr. Rafael I. Barraquer Titular de la Càtedra 25.III.2009

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Càtedra de Recerca en Oftalmologia "Joaquim Barraquer" - UAB

1. Líneas de investigación en desarrollo 1.1 Proyecto Phaco Ersatz Reemplazamiento del material cristaliniano para recuperar la acomodación tras la cirugía de cataratas 1.1.1 Aparato para simular la acomodación ex vivo Ralph Michael, Marek Mikielewicz, Marta López, Rodolfo Carretié, Rafael I. Barraquer Institut Universitari Barraquer Hemos diseñado un aparato para medir las características mecánicas y ópticas dinámicas del cristalino durante la simulación de la acomodación ex vivo, que se puede utilizar tanto para el cristalino de ojos de donantes como para el cristalino después de la operación de catarata rellenando la cápsula con un polímero.

El globo del donante se secciona dejando el cristalino y el cuerpo ciliar para poner encima de un dispositivo. El dispositivo permite el estiramiento circunferencial del cristalino simulando la acomodación. El estiramiento se crea por un motor de pasos conectado a un micrómetro y a una balanza que permite medir el desplazamiento y la fuerza. La sección corneal del ojo se va a conectar mediante ocho suturas de Prolene al conjunto del micrómetro y de la balanza. El conjunto funciona haciendo pequeños desplazamientos de 1 a 100 µm con una resolución de 2 µm. El micrómetro tiene una salida digital que permite la medición del desplazamiento con una resolución de 1 µm. El núcleo de una balanza digital sirve para la medición de la fuerza de los estiramientos ligeros (1 a 500 mN) con una resolución de 0.1 mN. 1.1.1.1 Fijación del cristalino en el aparato Uno de los problemas de las mediciones de las características mecanico-ópticas del cristalino era la fijación de la pieza al aparato. El estiramiento circunferencial al que el aparato sometía al complejo cristalino-músculo ciliar debía ser lo más homogéneo posible.

Las primeras pruebas fueron con anzuelos que estiraban del músculo ciliar. Se colocaban ocho anzuelos alrededor de la pieza (compuesta de cristalino y músculo ciliar, la esclera no se incluía).

El resultado era una mala distribución del estiramiento sobre el cristalino.

Otras pruebas se realizaron con pegamento quirugico Histoacryl® sin obtener tampoco resultados satisfactorios. La fijación de la pieza al aparato resultaba alterada puesto que el pegamento provocaba un daño en el músculo ciliar. La pieza está inmersa en medio líquido dentro del recipiente del aparato y esto dificultaba la acción del pegamento.

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Càtedra de Recerca en Oftalmologia "Joaquim Barraquer" - UAB

Actualmente existen nuevas pruebas con microperlas de vidrio. La preparación de la pieza consta de varios pasos: se realizan marcas para las suturas en el globo a unos 3 mm del limbo con un anillo basculante de Thornton de 16 mm y con un marcador de queratectomía radial de 8 radios.

Sobre estas marcas se suturan los abalorios en los ocho meridianos, paralelos al limbo, de manera que tracen un círculo de unos 12-16 mm de diámetro.

Primero se recorta la esclera en sentido circunferencial (plano frontal) hasta separar por completo el casquete anterior, luego radialmente siguiendo las marcas esclerales del principio. Se debe separar del casquete la mayor cantidad de vítreo posible. La pieza resultante se sumerge en suero fisiológico dentro del recipiente del aparato.

Este método de fijación permite mejores resultados, ya que la distribución de la fuerza es más homogénea y se altera menos el complejo cristalino-músculo ciliar al conservar esclera.

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Càtedra de Recerca en Oftalmologia "Joaquim Barraquer" - UAB

1.2 Calidad óptica del ojo 1.2.1 Medición de la calidad de visión en pacientes post LASIK Intraocular straylight and contrast sensitivity two months after LASIK Ralph Michael, Gustavo A. Montenegro, Rafael I. Barraquer Institut Universitari Barraquer PURPOSE: To study the effect of Laser in-Situ Keratomileusis on intraocular straylight and contrast sensitivity.

METHODS: Altogether 46 eyes of 28 patients (mean age 30 years; refractive error range from 3.5 to -8.0 D) were treated for LASIK with Bausch & Lomb Technolas Z100 and studied pre-op and twomonth post-op. Intraocular straylight was measured with the Oculus C-Quant and contrast sensitivity with the CSV-1000 (at 3, 6, 12, 18 cycles/degree).

Principle of intraocular stray light measurements

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CĂ tedra de Recerca en Oftalmologia "Joaquim Barraquer" - UAB

RESULTS: Pre-op mean straylight parameter and mean contrast sensitivity at all four spatial frequencies did not change at two months post-op. Only one eye had straylight values increased by more than 0.25 log units. Nine eyes presented a decline of two or more positions in the CSV-1000 log scale at one or more spatial frequencies. Only two of those eyes had a clinical explanation for the decrease, one presented a light paracentral superficial punctuate keratitis and the other diffuse lamellar keratitis.

CONCLUSION: LASIK patients seem to fall in three groups; one group, the vast majority (80%) has no complications and maintains their visual quality as judged by contrast sensitivity and intraocular straylight. A few patients (16%) have no clinically significant complications but a slightly decreased visual quality. Very few (4%) have clinical complications with decreased visual quality.

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Càtedra de Recerca en Oftalmologia "Joaquim Barraquer" - UAB

1.2.2 Cuantificación de la luz dispersa en pacientes capsulotomía YAG Ralph Michael, Gustavo A. Montenegro, Conrad Latoche, Juan Carlos Reyes, Rafael I. Barraquer Institut Universitari Barraquer Purpose: To study the correlation of posterior capsule opacification (PCO) with measured intraocular straylight and visual acuity.

Methods: Visual acuity (logMAR) and intraocular straylight (C-Quant straylight parameter log[s]) were measured under photopic conditions before and 2 weeks after YAG capsulotomy in 20 patients.

The eyes with PCO were dilated and photographed at a slit lamp, illuminated with a wide slit beam under an angle of about 50 degrees to document the amount of opacification. Photopic pupil diameter was measured. Three masked observers graded the opacification inside the photopic pupil diameter on the PCO photographs on a scale from 0 to 10.

Retroillumination

Illuminated with a wide slit beam under an angle of about 50 degrees (same eye)

Results: The photographs at the slit lamp with a wide slit beam allow the visualization of optical imperfections inside the IOL and deposits on it, the light scattering from the posterior capsule opacification and even vitreous imperfections, some of which are missed with the retroillumination. Regression of visual acuity improvement (post-pre YAG) as function of PCOSlit lamp grading gave a coefficient of determination (R2) of 0.30. Regression of intraocular straylight improvement as function of PCO-slit lamp grading gave an R2 of 0.48.

Conclusions: PCO-Slit lamp grading, which considers backward light scattering, is weakly correlated with visual acuity and moderately correlated with intraocular straylight measured by the C-Quant.

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Càtedra de Recerca en Oftalmologia "Joaquim Barraquer" - UAB

1.3 Queratoprótesis y cultivo de células limbares 1.3.1 Resultados a largo plazo de osteo - osteoodonto - queratoprótesis Ralph Michael1, Victor Charoenrook1, Maria Fideliz de la Paz1, Wolfgang Hitzl2, Jose Temprano1, Rafael I. Barraquer1 1 2

Institut Universitari Barraquer Eye Clinic and Research Office, Paracelsus Medical University Salzburg

Purpose: To analyse the functional and anatomical results of keratoprosthesis using tooth and tibial autograft.

Methods: We reviewed 227 charts of patients that underwent osteo-keratoprosthesis (OKP) (n=82) or osteo-odonto-keratoprosthesis (OOKP) (n=145) at the Centro de Oftalmología Barraquer.

Mean follow-up time was 8.4 years for OOKP and 3.5 years for OKP. Kaplan- Meier survival curves with 95% confidence interval (CI) were calculated for functional success, defined as BCVA >0.05. Anatomical success was defined as retention of the keratoprosthesis lamina. Visual Acuity by Time (VAT) Index with 95% CI was calculated for up to 2 years post- OKP and up to 6 years post-OOKP. Maximum visual acuity ever reached after the last step of the implantation of the keratoprosthesis was used as an indicator for the potential of the retina.

Results: Based on Kaplan-Meier analyses, 10-year anatomical survival was 66% (CI 57–76) for OOKP and 47% (CI 27– 67) for OKP. Two-year functional survival was 63% (CI 55–71) for OOKP and 49% (CI 37–60) for OKP, and 10-year functional survival was 38% (CI 29–48) for OOKP and 17% (CI 5–28) for OKP. Multivariate analysis showed that neither surgical technique (OOKP or OKP), primary diagnosis nor age had a significant influence on the functional survival. However, a high maximum visual acuity ever reached post-op decreased the risk for functional failure. According to the VAT Index calculations, mean BCVA 2 years after OOKP was 0.33 (CI 0.28–0.41) and after OKP was 0.28 (CI 0.20–0.36).

Conclusion: Although we found a tendency that OOKP had better anatomical results than OKP, this difference was not statistically significant up to 10 years post-op. Functional results for both techniques were not significantly different at the 2-year follow-up, but at 10 years they were.

However, this difference was influenced by the retinal potential and not by the technique itself.

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Càtedra de Recerca en Oftalmologia "Joaquim Barraquer" - UAB

1.3.2 Proyecto Europeo: Córnea artificial Development of an Artificial Cornea for the Human Eye

CORONIS GMBH, München, Germany Centre of Medical Biotechnology, Regensburg University, Germany Fraunhofer Institute for Applied Polymer Research IAP, Potsdam, Germany Department of Ophthalmology; Halle University Medical Centre, Germany Dr. Schmidt Intraocularlinsen GmbH, St. Augustin, Germany Institut Universitari Barraquer Summary: SME-1 Co-operative Research (all areas of science and technology) Opacification of the cornea of the human eye results in the loss of vision and finally blindness unless corrected by a corneal transplant. In developed countries the standard surgical technology to restore vision is the replacement of the cornea by a human donor cornea in a penetrating keratoplasty.

More than 40.000 keratoplasties per year are performed in Europe and the United States each, with a continuous increase in recent years, and with success rates from more than 90 to less than 50 percent. Low success rates are associated with dry eyes, Herpes keratitis, corneal vascularization, recurring uveitis, acid burns, and traumatic anatomic structures of the anterior eye. The lack of donor corneas resulted in long waiting lists of patients in developed countries, and their non-availability in developing countries in millions of treatable blind people. There is a long history of attempts to replace the human cornea by alloplastic material with either disappointing results, or complicated multiple surgeries associated with severe drawbacks for the patient.

The CORNEA project will combine the invention of a novel corneal transplant by one SME partner with novel flexible ophthalmic polymers developed by a second, the manufacturing technology of a third, and the surgical instruments and technology of two more SME partners.

This combined SME know-how will be merged with the surface modification technology to be developed by one RTD partner and the ophthalmo-surgical expertise, and preclinical and clinical research capacities of two more RTD partners. Thus the project CORNEA will combine several cutting-edge technologies in order to achieve a never before available implant design and precision of surgery, and open the chance to regain vision for otherwise blind people. It will give a long-term competitive advantage and profit to the members of the consortium, and secure existing and create new working places.

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CĂ tedra de Recerca en Oftalmologia "Joaquim Barraquer" - UAB

1.3.3 Cultivo de cĂŠlulas limbares Maria Fideliz de la Paz, Juan Ă lvarez de Toledo, Rafael I. Barraquer Institut Universitari Barraquer Collaborative Research Project between Institut Universitari Barraquer, Schepens Eye Research Institute, Harvard Medical School, Boston, and Oslo University Hospital Ulleval, Norway

Introdcution Any process or disease that disturbs the integrity of the limbal stem cells which is located in the periphery of the cornea reduces the ability of the corneal epithelium to repopulate itself.

Inadequate repopulation of the corneal surface may be secondary to a loss in the number of limbal stem cells and/or reduced function of these cells. Limbal stem cell deficiency may occur in a variety of hereditary and acquired corneal diseases. The acquired causes are the most frequent,and includes UV-radiation, acid burns, autoimmune disorders, and infections, including trachoma, which affects about 80 million people worldwide. The clinical symptoms of limbal stem cell deficiency include irritation, epiphora, blepharospasms, photophobia, pain and decreased vision.

Our research team works on various strategies for treating limbal stem cell deficiency. There are many ways to treat limbal stem cell deficiency. The most studied and promising recent technique is the method first described by Pellegrini et al in Lancet in 1997 called ex vivo expansion of limbal epithelial cells. The principle of the method is to transfer human limbal epithelial cells harvested from the patient itself, a living relative, or a cadaver cultured on various substrates in the laboratory onto the eyes of patients suffering from limbal stem cell deficiency.

Current technology Several clinical studies have demonstrated very promising results of ex vivo expansion of limbal epithelial cells for treating limbal stem cell deficiency. However, there are many disadvantages of the current method: Firstly, the extensiveness of the method has been limited as it requires, in addition to adequate cell culture equipment, knowledge and experience of culturing limbal epithelial cells. Secondly, planning of the treatment has been a logistical nightmare as not all cultures succeed, i.e. no or little growth, alternatively get perceptibly infected (yellow medium/increased turbidity). Under these circumstances, the planned operations are cancelled.

An obvious infection may also be noticed as late as on the operation day, which is especially regrettable for patients travelling long distances. Thirdly, lack of sterility control, i.e. the transplants may be infected without any noticeable colour/turbidity change of the medium, resulting in operation of infected tissue.

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CĂ tedra de Recerca en Oftalmologia "Joaquim Barraquer" - UAB

New technology The Department of Ophthalmology at Ulleval University Hospital (Oslo, Norway) is the first to demonstrate the feasibility of storing cultured corneal epithelium. A patent application was filed on April 26, 2007 to protect the method of culture, storage, transportation, and microbiological assessment of human limbal epithelial cells (HLECs). The patent application also includes design of a kit for optimizing the process of culture and storage. The novel method has several benefits: 1) Storage of cultured corneal epithelium enables tissue to be transported from the laboratory to eye banks and eye departments worldwide. Compared to the surgical procedure, which is considered relatively simple, culture of corneal epithelium is resource-demanding accounting for the imbalance between kinds of treatment and treatment demands.

2) The tissue can be preserved at room temperature, which is an asset as the need for a heating cabinet is eliminated, simplifying logistics and reducing costs.

3) The production of cultured corneal epithelium at few centre of expertise is cost effective and may improve the quality of corneal tissues. European Union Directives* (on setting standards of quality and safety for the donation, procurement, testing, processing, preservation, storage, and distribution of human tissues and cells) make strict demands on tissue engineering laboratories and will contribute to the centralisation of tissue production, hence increasing the demand for tissue storage and transportation. (*Directive 2004/23/EC of the European Parliament and of the Council of 31 March 2004, Commission Directive 2006/17/EC of 8 February 2006, and Commission Directive 2006/86/EC of 24 October 2006).

4) The transplants are eventually stored in a closed container, in contrast to the open culture setting where infection may occur at any time. As the tissue can be stored in at least one week, there is sufficient time to perform microbiological testing. Current insecure methods based on changes of the colour and turbidity of the medium are replaced by more polite and exact diagnostics.

5) Tissue storage maintains the original characteristics of the tissue for at least one week, hence offering flexibility in scheduling the transplantation.

6) Possibly reduced need for immunosuppression (reduced nuclear factor kB activity). However, further studies are warranted.

Future perspecitives The advantages of storing limbal epithelial cells, apply equally to other cultured cell types. Hence, we are currently working on storage and transportation of conjunctival epithelial cells based on our experiences from limbal epithelial cells. In the near future we plan to expand to new cell types. Simultaneously, we will work on improving the culture and storage protocols for treating limbal stem cell deficiency.

Merits for the research group Since 2007 the original project, led by Torstein Lyberg, has resulted in 20 publications, two patent applications, extensive funds, publicity (EuroNews, which is the largest news channel in Europe, among others), extensive international collaboration, and three research awards last year.

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Càtedra de Recerca en Oftalmologia "Joaquim Barraquer" - UAB

1.4 Enfermedades congénitas 1.4.1 Catarata congénita Lourdes Ruiz, Maria Fideliz de la Paz, Ralph Michael, Rafael I. Barraquer Institut Universitari Barraquer Objetivo: Estudiar el error refractivo y la agudeza visual post quirúrgica, a lo largo del tiempo, en niños operados de catarata congénita, con implante primario de lente intraocular.

Métodos: Evaluación de la agudeza visual, medido con el optotipo de Snellen para los niños que colaboraban y el test de Teller para los más pequeños. El resultado del equivalente esférico fue obtenido mediante refracción por esquiascopia y autorrefractometria, para dicho estudio se dividió en tres grupos de edad, (6-18 meses, 19-36 meses; mayores a 36 meses) tanto pre quirúrgico, como a los 2 meses, 6 meses, al año, a los 2 años y a los 3 años post cirugía.

Graficamos la agudeza visual y el equivalente esférico en función a la edad. Para mejor estudio también se agruparon los pacientes, relacionando la agudeza visual y el equivalente esférico, con los que no tenían ninguna patología ocular asociada, los que tenían estrabismo, y otras patologías (nistagmus, microftalmía, papila morning glory, persistencia de vítreo primario hiperplásico, vasculosa lentis, lenticono posterior). También agrupamos las cataratas unioculares por un lado y las cataratas binoculares por otra , relacionando con la agudeza visual y el equivalente esférico.

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Càtedra de Recerca en Oftalmologia "Joaquim Barraquer" - UAB

Resultados: La mayoría de los pacientes presentan una notable mejoría de la agudeza visual entre los 2 – 3 años post cirugía, comparado con los primeros años post cirugía, El equivalente esférico alcanzado fue más estable y próximo al objetivo en los pacientes mayores a 20 meses de edad, sin patología de base, o estrabismo (aproximadamente entre + 2 y – 2), a diferencia de los pacientes que tenían otras patologías oculares, que además presentaron agudeza visual muy baja.

Aproximadamente el 40 % de los pacientes lograron una agudeza visual 0.5 o mejor. También hay una notable mejoría de la agudeza visual en pacientes con catarata binocular comparada con la uniocular .

Conclusión: En los pacientes de 20 semanas o menos, con patologías oculares asociadas, no se llegó a la agudeza visual y el equivalente esférico esperado, si fueron más alentadores los resultados en los pacientes mayores a esta edad, sin patología ocular. Los pacientes con estrabismo presentaron un equivalente esférico aceptable, pero pobre agudeza visual. La catarata uniocular, como esta descrito en la literatura resulta más ambliopizante que la binocular.

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Càtedra de Recerca en Oftalmologia "Joaquim Barraquer" - UAB

1.4.2 Aniridia congénita Long-term visual prognosis of corneal and ocular surface surgery in patients with congenital aniridia Maria Fideliz de la Paz, Juan Álvarez de Toledo, Rafael I. Barraquer and Joaquin Barraquer Institut Universitari Barraquer

Purpose: To evaluate the long-term visual prognosis of corneal and ocular surface surgery in patients with congenital aniridia.

Methods: Retrospective comparative interventional case series on 88 eyes of 45 patients with congenital aniridia treated and ⁄ or operated on from 1956 to present. Corneal and ocular surface findings were identified and patients were classified into operated (group I) or not operated (group II).

Long-term bestever best-corrected visual acuity (BCVA), final BCVA and long-term delta BCVA (long-term best-ever BCVA – final BCVA) were recorded and compared between the two groups, and between the limbal transplant (LT) (group I-A) and the penetrating keratoplasty (PK) (group I-B) patients. Postoperative results were also compared.

Results: Limbal insufficiency was present in 58% of eyes and dense central corneal opacities were present in 27% of eyes. As a primary surgery, limbal allograft was performed in 10 eyes and PK in 13 eyes. The mean long-term follow-up times were 23 years in group I and 16 years in group II. The mean long-term delta BCVA was 0.032 in group I and 0.028 in group II. Comparisons of the VA means were insignificant (long-term best-ever, final BCVA and long-term delta BCVA). When comparing the LT and PK groups, mean longterm delta BCVA was 0.0328 in group I-A and 0.0382 in group I-B. Mean postoperative delta BCVA was 0.028 in group I-A and 0.048 in group I-B. We found no statistical significance between the LT and the PK groups as regards long-term postoperative BCVA results.

Conclusion: Long-term visual prognosis does not differ whether or not the patient undergoes surgery for aniridic keratopathy. LT and PK have comparable results over 5 years of follow-up because of the eventual failure of transplanted allografts.

Published in Acta Ophthalmol. 2008: 86: 735–740

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CĂ tedra de Recerca en Oftalmologia "Joaquim Barraquer" - UAB

Europe/Asia-Pacific Edition - December 2008 - OSNsupersite.com

Similar BCVA seen in congenital aniridia patients who underwent limbal autograft or PK Acta Ophthalmol. 2008;86(7):735-740.

No statistically significant difference was found in long-term postoperative best corrected visual acuity between eyes that underwent limbal transplantation or penetrating keratoplasty in patients with congenital aniridia.

In addition, a statistically significant difference was not found in long-term BCVA between operated and non-operated eyes.

The retrospective, interventional case series compared 88 eyes in 45 patients with congenital aniridia who underwent treatment between 1956 and the present. Corneal and ocular surface findings were identified, and patients were classified into two groups: those who had undergone operation and those who received another form of treatment. As primary surgery, limbal allograft was performed in 10 eyes and PK was performed in 13 eyes.

"Improvements in BCVA are difficult to measure because of other concomitant pathologies such as cataract, glaucoma and foveal hypoplasia," the researchers said. "Most of the patients are satisfied with the results when the grafts are functioning despite no statistically significant improvement in their BCVA." Glaucoma was found in 66% of eyes in the no-surgery group and in 62% of eyes in the surgery group.

PERSPECTIVE This study is further confirmation of the poor long-term visual prognosis in patients who undergo corneal and ocular surface surgery for congenital aniridia. The researchers found that visual prognosis is no different with or without keratoplasty.

Although the short-term visual prognosis was better with limbal transplant, there was no significant difference in the long term. These findings encourage a more conservative approach. Aniridia is a profibrotic disorder and, as a result, surgical intervention is more likely to fail. This study highlights the need for a different surgical approach such as the use of the Boston keratoprosthesis. This then requires long-term follow-up studies to evaluate visual prognosis, prosthesis failure and risk of infection. – Michael O’Keefe, MD Mater Private Hospital, Dublin, Ireland

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Càtedra de Recerca en Oftalmologia "Joaquim Barraquer" - UAB

2. Actividades docentes 2.1 Tesis de doctorado en desarrollo Evolución del astigmatismo a largo plazo tras queratoplastia penetrante en queratocono.

Dr. Juan P. Álvarez de Toledo Elizalde, Centro de Oftalmología Barraquer Resultados funcionales de la fotocoagulación láser mediante rejilla del edema macular diabético difuso.

Dr. Jerónimo Nadal Reus, Centro de Oftalmología Barraquer Lentes precristalinianas para la corrección de alta miopía.

Dr. Tahsin Martini, Hospital Martini, Aleppo, SIRIA Tutor: Prof. Joaquín Barraquer, Centro de Oftalmología Barraquer Endoftalmitis de etiología exógena. Revisión de datos clínicos.

Dra. Simona Nossa, Bergamo, ITALIA Tutor: Dr. Santos Muiños, Centro de Oftalmología Barraquer Alteraciones intraoculares secundarias a la cirugía de la catarata senil: estudio comparativo entre los ultrasonidos y el sistema Aqualase. Repercusiones en el endotelio corneal, barrera hematoacuosa y mácula.

Dr. Fabiano Brandao M. de Araujo, Brasil Tutor: Dr. Rafael I. Barraquer, Centro de Oftalmología Barraquer Capsulorhexis posterior: estudio del segmento posterior mediante OCT. Dra. Marcia Toledo, Centro de Oftalmología Barraquer Tratamiento de la hipermetropía con Fotoqueratomileusis según el frente de ondas Dra. Ana María Pascual Agúndez, Madrid Tutor: Dr. Rafael I. Barraquer, Centro de Oftalmología Barraquer Estudio comparativo entre cirugía de pequeña y micro - incisión: repercusiones en la barrera hematoacusa, endotelio corneal, anatomía macular y calidad visual Dr. Rodrigo Abreu González Tutor: Dr. Rafael I. Barraquer, Centro de Oftalmología Barraquer

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2.2 Trabajos de investigación Máster Máster de segmento posterior NOMBRE

TÍTULO

COORDINADOR

DRA. ASENCIO

Tinciones vitales en cirugía macular.

Dr. Nadal

DR. BARBERÁ

Bevacizumab (Avastin) intravítreo para el tratamiento de la MNC secundaria a miopía.

Dr. Abengoechea

DRA. BUIGUES

Terapia combinada en el tratamiento de la vasculopatía polipoidea.

Dr. Abengoechea

DRA. CAPELLA

Estudio comparativo de tres sistemas para cirugía microincisional (23 g) de vítreo-retina mediante microscopía electrónica de barrido.

Dr. Elizalde

DR. CHARAFEDDIN DRA. RODRÍGUEZ

Comparación clínica entre Bevacizumab y Ranibizumab en el tratamiento de la DMAE exudativa

Dr. Escoto

DR. ESPEJO

Rol del factor de crecimiento del endotelio vascular (VEGF) en las enfermedades del segmento posterior y uso de los agentes ante VEGF.

Dr. Escoto

DRA. ESPINO

Resultados Visuales y complicaciones de la Terapia Fotodinámica aplicada a pacientes con Corioretinopatia Serosa Central Crónica.

Dr. Abengoechea

DRA. GARCÍA ROLDÁN

Retinopatía de la prematuridad.

Dr. Nadal

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Máster de segmento posterior NOMBRE

TÍTULO

COORDINADOR

DR. GIOINO DR. RECANCOF DR. VITTORINO

Actualización de el uso de Bevacizumab (Avastin ®) intravitreo en le tratamiento del edema macular secundario a obstrucción de vena central de la retina.

Dr. Escoto

DR. LAJO

Evaluación ecográfica en modo B y con tomografía óptica de coherencia de las membranas epirretinales maculares.

Dr. Muiños

DRA. LÓPEZ TORRES

Determinar la eficacia como terapia neoadyuvante del Bevacizumab en pacientes con Edema Macular Diabético.

Dr. Elizalde

DR. MARTINS DR. RUÍZ RODRIGUEZ

Impacto de la introducción de la Vitrectomia 23G en un Hospital Distrital en Portugal.

Dr. Nadal

DR. OLIVERA

Planimetría digital de lesiones intraoculares.

Dr. Nadal

DRA. PIÑERO

Tratamiento quirúrgico de las hemorragias masivas maculares.

Dr. Nadal

DRA. RUIZ VERA DR. CARRÓN DR. LATOCHE

Cirugía membrana epiretiniana mediante VVPP 23 G.

Dr. Elizalde

DRA. SAUVAGEOT

Efecto de AVASTIN en membrana neovasculares miópicas.

Dr. Abengoechea

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Máster de segmento anterior NOMBRE DR. ÁLVAREZ LÓPEZ

TÍTULO Bevacizumab (Avastinâ) intravítreo en el tratamiento del glaucoma neovascular

COORDINADOR Dra. Canut

DR. CARRÓN ALVARADO

Fijación escleral de LIO de cámara posterior en ausencia de soporte capsular. Resultados y complicaciones

Dra. Canut

DRA. VERDAGUER

Relación del lago escleral con el Dra. Canut control de la presión intraocular en el postoperatorio de una esclerotomía profunda no perforante

DRA. CAPELLA ELIZALD

Revisión quirúrgica de la ampolla de filtración en casos de hipotonía no controlada tras cirugía filtrante

Dra. Canut

DR. FONSECA MARTINS Revisión bibliográfica sobre pseudoexfoliación del cristalino y cirugía de catarata

Dr. Samaan

DRA. MARTÍNEZ MARTÍNEZ

Esclerotomía profunda no perforante. Técnicas y resultados

Dr. Samaan

DRA. ESPINO CALDERÓN

Complicaciones postoperatorias en Dr. Garcia Barberán pacientes con indicación primaria de facoesclerotomía profunda no penetrante que requieren conversión a facotrabeculectomía

DRA. SAUVAGEOT BENERIA

Hipotensores para reducir la miopía residual post-LASIK

Dr. Barraquer Dr. Picó

DR. RECANCOF GARCÍA DR. VITTORINO

Modulación de la cicatrización de heridas en la cirugía filtrante del glaucoma. Revisión bibliográfica.

Dr. Ruíz Tolosa

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Máster de segmento anterior NOMBRE DRA. BUIGUES LLULL DRA. RODRÍGUEZ MAIZTEGUI

TÍTULO Recidiva de distrofias corneales tras queratoplastia

COORDINADOR Dr. Barraquer

DRA. HUA

IOL power calculation in patients after corneal refractive surgery

Dr. Barraquer Dra. de la Paz

DRA. RUÍZ VERA

Resultados funcionales y refractivos tras la cirugía de catarata congénita

Dr. Barraquer Dra. de la Paz

DR. CHARAFEDDIN ABOUL-HOSN

Biomicroscopia confocal en Dr. Barraquer distrofias y degeneraciones corneales

DR. MARCH

El Síndrome de Iris Flácido Intraoperatorio (Intraoperative Floppy Iris Sindrome: IFIS) y otras causas de miosis intraoperatoria en cirugía de catarata

Dr. Barraquer

DRA. LLANOS

Determinación de las propiedades biomecánicas de la córnea en pacientes operados de LASIK

Dr. Barraquer Dr. Michael

DR. LATOCHE ROJAS DR. REYES

Deslumbramiento y cuantificación de Dr. Barraquer la luz dispersa en el ojo en pacientes Dr. Michael pre y post capsulotomía YAG

DRA. LOBATO GARCÍA

Presencia de beta amiloide en cataratas corticales de pacientes con Alzheimer

Dr. Barraquer Dr. Michael

DR. MONTENEGRO MARTÍNEZ

Dispersión de luz intraocular y sensibilidad de contraste después de LASIK

Dr. Barraquer Dr. Michael

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2.3 Actividades en organizaciones nacionales e internacionales 2.3.1 European Association for Vision and Eye Research El Dr. Ralph Michael trabaja en la asociación como "Miembro de la Junta" y "Presidente de la sección de Catarata y Lente". En el 2007 fue elegido "Vicepresidente" para el año 2008/2009.

EVER Executive Board 2008/2009

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2.3.2 Acta Ophthalmologica El Dr. Ralph Michael trabaja en la junta como "Editorial Board Member" de la revista Acta Ophthalmologica Scandinavica.

Print ISSN: 1395 -3907 Online ISSN: 1600-0420 Chief Editor Einar Stef ánsson, Iceland Board of Directors Anders Heijl, Sweden Gunnar Høvding, Norway Fridbert Jónasson, Iceland Anna Midelfart, Norway Thomas Olsen, Denmark Jan Ulrik Prause, Denmark Einar Stefánsson, Iceland Lotta Salminen, Finland Stefan Seregard, Sweden Hannu Uusitalo, Finland Charlotta Zetterstr öm, Sweden Amanda Churchill, United Kingdom Per S öderberg, Sweden Co-Editors Anders Heijl, Sweden Emilia Kerty, Norway Tero Kivel ä, Finland Morten la Cour, Denmark Per Montan, Sweden Kristina Tornqvist, Sweden Michael Wall, USA Charlotta Zetterstr öm, Sweden

Editorial Board Elisabeth Agardh, Sweden Juhani Airaksinen, Finland Charlotta All-Ericsson, Sweden Albert Alm, Sweden Sten Andr éasson, Sweden Toke Bek, Denmark Harlinder Dua, United Kingdom Niels Ehlers, Denmark Per Fagerholm, Sweden Hans Fledelius, Denmark Thomas W. Gardner, USA Erling Haaskjold, Norway Ivan Haefliger, Switzerland Alon Harris, USA David Henson, United Kingdom Graham Holder, United Kingdom Gunnar Høvding, Norway Jost B. Jonas, Germany Erich Knop, Germany Leila Laatikainen, Finland Michael Larsen, Denmark Lene Martin, Sweden Ralph Michael, Spain Sven Erik Nilsson, Sweden Selim Orgul, Switzerland Uwe Pleyer, Germany Jan Ulrik Prause, Denmark Charles Riva, Italy Eyvind R ødahl, Norway Matti Saari, Finland Stefan Seregard, Sweden Haraldur Sigurdsson, Iceland

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2.3.3 European Vision Institute - Clincal Trials

EVI.CT.SE Clinical Trials.Sites of Excellence European Vision Institute. Clinical Trials. Sites of Excellence (EVI.CT.SE) is a network of European Ophthalmological Clinical Research Sites, dedicated to perform clinical research in ophthalmology with the highest standards of quality, following the European and International Directives for clinical trial research.

The Centro de Oftalmologia Barraquer is part of this network since 2007.

The EVI.CT.SE is a Special Committee of the European Vision Institute, European Economic Interest Grouping (EVIEEIG) legally constituted in 2003 under European law as a not-forprofit, science–driven organisation in Brussels.

The office of EVI.CT.SE is located in Coimbra, Portugal, upon decision of the General Assembly of the EVIEEIG, held in Vilamoura, 2004.

2. Main objectives - Organization of multicentric clinical trials in ophthalmology in Europe - Performance of multicentric clinical trials in ophthalmology with the highest level of quality.

- Assume EVI.CT.SE as a resource for Healthcare Industry.

- Establish rapid and regular communication links between the Healthcare Industry and the EVI.CT.SE members.

- Create synergies between members and promote clinical research programmes in order to establish clinical trial research in Europe.

- Establish programmes for regular educational and training activities for its members.

- Create an alternative to USA to perform Phase 1 and 2 studies - Create groups of experts for Clinical Trial design in specific areas of ophthalmological research.

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European Vision Institute. Clinical Trials. Sites of Excellence: Clinical Sites with Full Certification: - CS nº 1 - AIBILI, Coimbra, Portugal - CS nº 24 - University of Freiburg, Department of Ophthalmology, Freiburg, Germany Clinical Sites with Conditional Certification: - CS nº 2 - Johannes Gutenberg University, Department of Ophthalmology, Mainz, Germany - CS nº 5 - Faculty of Medicine Mannheim of the RuprechtKarls–University Heidelberg, Department of Ophthalmology, Mannheim, Germany - CS nº 6 - Centre National d’Ophthalmologie des QuinzeVingts, Centre d’Investigation Clinique, Paris, France - CS nº 7 - VISSUM - Instituto Oftalmologico de Alicante, Alicante, Spain - CS nº 8 - Ghent University Hospital, Department of Ophthalmology, Ghent, Belgium - CS nº 9 - Universitäts-Augenklinik Tübingen (UAK), Tuebingen, Germany - CS nº 10 - Moorfields Eye Hospital NHS Foundation Trust, Clinical Trials Unit and Reading Centre, London, United Kingdom - CS nº 11 - University Eye Hospital Munich, Germany - CS nº 12 - University Hospital Antwerp, Department of Ophthalmology, Antwerp, Belgium - CS nº 13 - CHU Gabriel Montpied, Unité de Recherche Clinique, Service d’Ophthalmologie, Clermont-Ferrand, France - CS nº 15 - University of Bonn, Department of Ophthalmology, Bonn, Germany - CS nº 16 - University of Milan, Centre for Clinical Trials at San Paolo Hospital, Milan, Italy - CS nº 17 - University Medical Centre St Radboud, Macula Trial Centre Nijmegen, Netherlands - CS nº 19 - Medical University of Vienna, Department of Ophthalmology, Vienna, Austria - CS nº 20 - G. B. Bietti Foundation - IRCCS, Roma, Italy - CS nº 25 - Academic Medical Center, Department of Ophthalmology, Amsterdam, The Netherlands - CS nº 26 - Centro de Oftalmología Barraquer, Barcelona, Spain - CS nº 27 - University Eye Hospital, Leipzig, Germany

Clinical Sites implementing SOPs and that have had an EvaluationVisit - CS nº 4 - IOBA – Instituto Universitario Oftalmobiologia, Valladolid, Spain - CS nº 14 - Hôpital Lariboisière, Service D’Ophthalmologie, Paris, France - CS nº 21 - University Medical Center Hamburg-Eppendorf, Department of Ophthalmology, Hamburg, Germany - CS nº 30 - Glostrup Hospital, Department of Ophthalmology, Copenhagen University, Glostrup, Denmark - CS nº 36 - Catholic University, Institute of Ophthalmology, Rome, Italy - CS nº 37 - Sezione di Oftalmologia, Dipartimento di Scienze Otorino- Odonto-Oftalmologiche e Cerv. Facc., Parma Clinical Sites implementing SOPs and have not yet had an Evaluation Visit: - CS nº 3 - Centre Hospitalier Creteil, University Eye Clinic, Paris, France - CS nº 18 - University Hospital Leuven, Department of Ophthalmology, Leuven, Belgium - CS nº 22 - Universitäts – Klinik und Poliklinik für Augenheikunde, Bern, Switzerland - CS nº 23 - University Medical Centre of Ljubljana, University Eye Hospital, Ljubljana, Slovenia - CS nº 28 - Instituto de Oftalmologia Dr. Gama Pinto, Lisbon, Portugal - CS nº 29 - Instituto Galego de Oftalmoloxia, Santiago de Compostela, Spain - CS nº 31 - Mater Misericordiae University Hospital, McCauley Education and Research Center, Mater Vision Institute (MVI), Dublin, Ireland - CS nº 32 - Porto Medical School / Hospital S. João, Department of Ophthalmology, Porto, Portugal - CS nº 33 - Poznan University of Medical Sciences, Department of Ophthalmology, Poznan, Poland - CS nº 34 - University of Milan, Luigi Sacco Hospital, Department of Ophthalmology, Milano, Italy - CS nº 35 - Queen’s University, Institute of Clinical Science, Royal Victoria Hospital Ophthalmology And Vision Science Research Center, Belfast, United Kingdom - CS nº 38 - Institut Català de Retina, Barcelona, Spain - CS nº 39 - Clinica Oculistica, Università di Padova, Italy - CS nº 40 - Department of Ophthalmology, Rotterdam Eye Hospital, Rotterdam, The Netherlands CS nº 41 - Institut de la Màcula i de la Retina, Centro Médico Teknon, Barcelona, Spain

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Càtedra de Recerca en Oftalmologia "Joaquim Barraquer" - UAB

European Vision Institute EEIG Clinical Trials. Sites of Excellence EVI.CT.SE EVI.CT.SE Member Certificate N° ECS 26/2008 Valid through the period: 2008/APR - 2010/MAR

CENTRO DE OFTALMOLOGIA BARRAQUER

C/ Muntaner 314 E-08021 Barcelona -Spain

EVI.CT.SE Azinhaga de Santa Comba, Celas 3000-548 Coimbra . Portugal T + 351 239480100 F + 351 239480117

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3rd EVI.CT.SE Members Meeting 17/18 November 2008 Alicante, Spain The 3rd EVI.CT.SE Members Meeting was held on 17/18 November 2008 in Alicante (Spain) where a present status of the Network regarding the Steering Committee, the Expert Committees, the certification of the Clinical Site and Clinical Trials through EVI.CT.SE Network was made. There were brief presentations of the new Clinical Site Members (CS 43, CS 45, CS 47, CS 48, CS 49, CS 50 and CS 52), parallel meetings of the Scientific Sections (Retina; Glaucoma; Cornea, Cataract and Refractive Surgery; Ocular Surface and Inflammation and Reading Centres), lectures on Quality Assurance Systems and presentation of the Clinical Research Networks DRCR.net (USA) and Four Nations Eye Research (UK). Also 2 parallel sessions on GCP update for Investigators and GCP update for Study Coordinators occurred.

There were meetings of the Industry Advisory Board, the Steering Committee and of the Expert Committees.

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2.3.4 Redes Temáticas de Investigación Cooperativa

El Instituto Universitario Barraquer junto con la Universidad Autónoma de Barcelona presenta su solicitud para participar en la red temática Patología Ocular del Envejecimiento, Calidad Visual y Calidad de Vida, subproyecto Calidad de Vida y Cirugía del Dioptrio Ocular en mayo de 2007. La solicitud es aprobada en noviembre de 2007.

REDES TEMÁTICAS DE INVESTIGACIÓN COOPERATIVA (RETICs) El Instituto de Salud Carlos III es un organismo público de investigación con carácter de organismo autónomo, adscrito al Ministerio de Sanidad y Consumo, cuya misión es desarrollar y ofrecer servicios científico-técnicos de la más alta calidad dirigidos al Sistema Nacional de Salud y al conjunto de la sociedad. En materia de fomento de la investigación en salud, la Ley de Cohesión y Calidad del Sistema Nacional de Salud le encomienda a este Organismo público, en el ámbito de las competencias del Estado, funciones de planificación de la investigación, vertebración de los recursos dedicados a ella, difusión y transferencia de resultados, y desarrollo de programas de investigación, entre otras.

Las RETICs son estructuras organizativas formadas por la asociación al Instituto de Salud «Carlos III» de un conjunto variable de centros y grupos de investigación en biomedicina, de carácter multidisciplinar, dependientes de las diferentes Administraciones públicas o del sector privado y pertenecientes a un mínimo de cuatro Comunidades Autónomas, que tienen como objetivo la realización de proyectos de investigación cooperativa de interés general.

Responden a las prioridades del Plan Nacional de Investigación Científica, Desarrollo e Innovación Tecnológica en el ámbito sanitario e integran los distintos tipos de investigación como estrategia para acortar el intervalo entre la producción de un nuevo conocimiento y su transferencia y aplicabilidad real en la práctica médica.

Hoy en día hay aprobadas 69 Redes Temáticas en campos como la Cirugía, la Geriatría, la Oncología, Farmacología y Terapéutica, Bioquímica y Biología Celular.

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Red temática Patología Ocular del Envejecimiento, Calidad Visual y Calidad de Vida, subproyecto Calidad de Vida y Cirugía del Dioptrio Ocular OBJETIVOS Y LÍNEAS DE TRABAJO A DESARROLLAR: La creación de este Nodo pretende implementar las líneas de investigación comunes ya existentes, evitando la duplicación de esfuerzos y de equipamiento, completando las acciones investigadoras, permitiendo su ampliación en base a recursos compartidos y, en la medida de lo posible, la generación de tecnología.

Su objetivo general es la mejora de la calidad de vida mediante la manipulación quirúrgica del dioptrio ocular normal y patológico.

Para conseguir este objetivo se desarrollará una

investigación básica y clínica colaborativa encaminada a la consecución de una mejora en la calidad visual mediante procedimientos quirúrgicos realizados sobre el cristalino, sobre la córnea u otros elementos refractivos del ojo.

Para ello, se propondrá: el desarrollo de 6 líneas de investigación y de una serie de plataformas comunes de investigación, la creación de Biobancos, un plan de trabajo con su correspondiente cronograma de investigación y un plan general de actividades, que incluya un plan de formación del personal investigador

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SUBPROYECTO Calidad de Vida y Cirugía del Dioptrio Ocular Coordinador del Nodo: Jorge L Alió Título de la Red: Patologías oculares del envejecimiento y mejora de la calidad de vida.

Subproyecto: Calidad de Vida y Cirugía del Dioptrio Ocular GRUPOS DE INVESTIGACIÓN INVOLUCRADOS EN ESTE NODO

1. Universidad de Alcalá de Henares, Departamento de Cirugía, Área de Oftalmología 2. Fundación Privada Doctor Carlos Vergés, Barcelona 3. Universidad de Murcia. Laboratorio de Óptica 4. Universidad de Navarra, Servicio de Oftalmología, Clínica Universitaria de Navarra.

5. Instituto Gallego de Oftalmología, (Grupo de la Red C03/13) 6. Universidad de Santiago de Compostela, E.U de Óptica y Optometría, 7. Universidad de Santiago de Compostela. Área de Óptica 8. Universidad de Valladolid, Instituto Universitario de OftalmoBiologia Aplicada, (Grupo de la Red C03/13)

9. Consejo Superior de Investigaciones Científicas, Instituto de Óptica Daza de Valdés, Madrid 10. Universidad de Granada, Departamento de Óptica 11. Universidad Miguel Hernández, Departamento Psicología de la Salud 12. Universidad Miguel Hernández, Departamento de Ciencia y Tecnología de Materiales 13. Universidad Politécnica de Valencia, Centro de Biomateriales GRUPOS CLÍNICOS ASOCIADOS

14. Universidad Autónoma de Barcelona, Institut Universitari Barraquer, Barcelona 15. Hospital Clínico Universitario San Carlos, Madrid 16. Conselleria de Sanidad, Comunidad Autónoma de Murcia 17. Fundación ICHUVI, Complejo Hospitalario Universitario de Vigo 18. Fundación Andaluza de Investigación Oftalmológica

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2.4 Formación y cursos 2.4.1 Transparency Club Meetings Grupo de Investigación Segmento Anterior: Cada mes se ha organizado una reunión llamada "Transparency Club" o "Club de Transparencia". El nombre es debido a una de las características más importantes de la córnea y del cristalino. Participan en el grupo los oftalmólogos especializados en segmento anterior, los residentes y alumnos máster interesados en el segmento anterior, y también el equipo del departamento de cirugía refractiva. Se tratan temas clínicos y experimentales en forma de discusión, "brain storming" y ponencias.

Meetings 2008: Wednesday, 17 Dec 2008, 14:00

Wednesday, 18 June 2008, 14:00

- Summary from the Congress of "Corneal

Results from Master projects

Cross-Linking" in Dresden - European Project: Biometric data of the human eye (Gullstrand) Wednesday, 26 Nov 2008, 14:00 - Red Español de Investigación sobre

Tuesday, 6 May 2008, 14:00 Retinal implants Wednesday, 9 April 2008, 14:00 Intrastromal rings

keratoconus (RETCIS, Alicante)

Wednesday, 12 March 2008, 14:00

- Como hacer estadística con datos de

- Artificial cornea (US Patent)

agudeza visual (logMAR)

- Tissue engineered corneal substitutes

Wednesday, 29 Oct 2008, 14:00

- SupraDescemetic synthetic cornea

Crosslinking and Intrastromal rings

Wednesday, 13 Feb 2008, 14:00

Doctoral thesis: change of admission at UAB

Scheimpflug videography

Wednesday, 10 Sept 2008, 14:00

Wednesday, 9 Jan 2008, 14:00

Research projects 2008/09

- Straylight and contrast sensitivity after LASIK

Doctoral thesis as compendium

- Straylight after YAG capsulotomy

Wednesday, 16 July 2008, 14:00 Research projects 2008/09

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3. Publicaciones 3.1 Publicaciones en revistas Michael R, Barraquer RI, Willekens B, van Marle J, Vrensen GFJM. Morphology of age-related cuneiform cortical cataracts: the case for mechanical stress.

Vision Res. 2008 Feb;48(4):626-34.

Michael R, Charoenrook V, de la Paz MF, Hitzl W, Temprano J, Barraquer RI. Long-term functional and anatomical results of osteo- and osteoodonto-keratoprosthesis.

Graefes Arch. Clin. Exp. Ophthalmol. 2008 Aug;246(8):1133-7.

Mayo I, Puchades F, de la Paz MF. Topical fusidic acid for treatment of Clostridium perfringens Keratitis.

Cornea 2008 Sep;27(8):959-60. de la Paz MF, Álvarez de Toledo J, Barraquer RI, Barraquer J. Long-term visual prognosis of corneal and ocular surface surgery in congenital aniridia.

Acta Ophthalmol 2008 Nov; 86(7):735-40

3.2 Publicaciones de libros y capítulos de libros Elizalde J, Álvarez A, Piñero A, Barraquer RI. Tumores vasculares de la retina y la coroides.

Editor: Javier Elizalde, Depósito Legal: B.45597-2008 Barraquer RI & Charoenrook V. Leczenie skrzydlika.

In: Choroby rogówki, twardówki i powierzchni oka.

Redakcja: Zbigniew Zagórski,Gottfried Nauman & Peter Watson. Czelej, Lublin 2008 Barraquer RI & Charoenrook V. Tratamiento del Pterigium.

En: Enfermedades de la cornea, esclera y de la superficie ocular.

Editores: Zbigniew Zagórski,Gottfried Nauman & Peter Watson. Czelej, Lublin 2008

3.3 Presentaciones en congresos internacionales Michael R, Barraquer RI, Willekens B, van Marle J, Vrensen G. Could Cortical Cataracts Be Induced By Accommodation Forces? Association for Research in Vision and Ophthalmology 2008, Ft. Lauderdale, USA. Poster presentation. Invest Ophthalmol Vis Sci. 2008;49: E-Abstract 3795.

S. Raeder, T. Paaske Utheim, Ø. Aass Utheim, M. de la Paz, J.R. Eidet, T. Lyberg. Eye Bank Storage of Cultured Corneal Epithelium: Sterility Testing of Storage Media, Long-Term Preservation, and Deepithelialization of the Amniotic Membrane Substrate. Association for Research in Vision and Ophthalmology 2008, Ft. Lauderdale, USA. Poster presentation. Invest Ophthalmol Vis Sci. 2008;49: E-Abstract 5717.

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T. Utheim, S. Raeder, O.K. Olstad, O. Utheim, M. de la Paz, W.B. Medin, B. Roald, T. Lyberg.

Identification of Predilection Target Sites for Tissue Harvesting in Corneal Epithelial Tissue Engineering.

Association for Research in Vision and Ophthalmology 2008, Ft. Lauderdale, USA. Poster presentation. Invest Ophthalmol Vis Sci. 2008;49: E-Abstract 5746.

R.M. Corrales, A. De la Mata, M. Lopez, V. Saez, M. De la Paz, M. Calonge A New Method for Quantifying Limbal Stem Cell Markers. Association for Research in Vision and Ophthalmology 2008, Ft. Lauderdale, USA. Poster presentation. Invest Ophthalmol Vis Sci. 2008;49: E-Abstract 6074.

R.M. Sanabria, J.C. Pastor, I. Fernández, M. Alfaiate, A. Navea, J. Elizalde, J. Rojas, R. FernandezQuispe, L. Cordoves, E. Rodriguez de la Rua. Is It Necessary to Add a Scleral Buckle When Doing a Pars Plana Vitrectomy for Primary Repair of Rhegmatogenous Retinal Detachment? The Retina 1 Project, Report 3 Association for Research in Vision and Ophthalmology 2008, Ft. Lauderdale, USA. Oral presentation. Invest Ophthalmol Vis Sci. 2008;49: E-Abstract 4054.

Michael R, Barraquer RI, Vrensen G. How could cortical cataracts be induced by accommodation forces?

Accommodation Club 2008, Miami, USA. Oral presentation.

J. Elizalde, Michael R, Barraquer RI. Techniques de biopsie des mélanomes de l’uvée pour analyse cytogénétique.

Congres de la Societe Francaise d'Ophtalmologie 2008, Paris, F. Oral presentation.

Michael R, Barraquer RI, Vrensen G. Morphological link between accommodation, presbyopia and cortical cataract. European Association for Vision and Eye Research 2008, Portoroz, Slovenia.

Oral presentation. Acta Ophthalmologica. 2008;86 (s243) E-Abstract 5441 Barraquer RI, Michael R. Clinical use of multifocal and focus shift IOLs. European Association for Vision and Eye Research 2008, Portoroz, Slovenia. Oral presentation. Acta Ophthalmologica.

2008;86 (s243) E-Abstract 6142 de la Paz M, Álvarez de Toledo J, Michael R, Barraquer RI, Barraquer J. Boston KPro experience in Barcelona. European Association for Vision and Eye Research 2008, Portoroz, Slovenia.

Oral presentation. Acta Ophthalmologica. 2008;86 (s243) E-Abstract 6334 Barraquer J. Sclerocorneal limbus transplantation. European Association for Vision and Eye Research 2008, Portoroz, Slovenia. Oral presentation. Acta Ophthalmologica. 2008;86 (s243) EAbstract 5332 Barraquer J. More than 50 years of experience with keratoprostheses. European Association for Vision and Eye Research 2008, Portoroz, Slovenia. Oral presentation. Acta Ophthalmologica. 2008;86 (s243) E-Abstract 6333

33

Càtedra de Recerca en Oftalmologia "Joaquim Barraquer" - UAB

Desde el departamento de investigación hemos participado con en total cinco presentaciones.

The Association for Research in Vision and Ophthalmology

34

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3795/A72

Abstract Title:

Could Cortical Cataracts Be Induced By Accommodation Forces?

Presentation Start/End Wednesday, Apr 30, 2008, 8:30 AM -10:15 AM Time: Location:

Hall B/C

Reviewing Code:

138 cataractogenesis - LE

Author Block:

R. Michael1, R.I. Barraquer1, B. Willekens2, J. van Marle3, G.F.J.M. Vrensen4.

1Institut Universitari Barraquer, Barcelona, Spain; 2The Netherlands Institute for Neuroscience, Amsterdam, Netherlands; 3Academic Medical Center, University of Amsterdam, Amsterdam, Netherlands; 4Leiden University Medical Center, Leiden, Netherlands.

Keywords:

445 cataract, 596 microscopy: electron microscopy, 404 accomodation

Purpose: Evaluation of the gross morphology, the location and the fiber cell architecture of cortical opacities in the aging human lens.

Methods: Altogether, 39 human donor lenses in the age range of 55-90 years with small focal opacities and cuneiform or spoke cataracts were obtained from the Corneabank Amsterdam. They were photographed in toto in frontal view using dark-field stereomicroscopy. Fifteen lenses were fixed, cut in axial slices and photographed the same way. Details of fiber cell architecture were investigated by fluorescent staining for membranes and by scanning electron microscopy.

Results: Small focal and cuneiform cortical cataracts are discrete opacities located at a specific depth below the capsule, and extending from the equatorial region in anterior and posterior direction. When measured equatorially, the most superficial part of the cuneiform opacities is at a mean depth of 510 µm below the capsule. A sharp border is observed, between the opacities with their disorganized fiber architecture and the transparent more superficial cortical and deeper nuclear layers, which show a regular fiber pattern. This border is at a mean depth of 700 µm below the capsular surface. No significant relationship is found between this depth and donor age. Close examination of the opacities revealed fiber folds, fiber undulations, fiber-to-fiber separations, fiber breaks, water lakes and fiber displacement.

Conclusions: Small cortical and cuneiform opacities are accompanied by changes in fiber structure and architecture mainly in the equatorial border zone between the lens nucleus and cortex. Because the lens cortex and nucleus have different viscoelastic properties in young and old lenses, we hypothesize that external forces during accommodation cause shear stress predominantly in this border zone. The location of the described changes suggests that these mechanical forces may cause fiber disorganization, small cortical opacities, and, ultimately, cuneiform cataracts.

Commercial Relationship:

R. Michael, None; R.I. Barraquer, None; B. Willekens, None; J. van Marle, None; G.F.J.M. Vrensen, None.

Support:

None

©2008, Copyright by the Association for Research in Vision and Ophthalmology, Inc., all rights reserved. Go to www.iovs.org to access the version of record. For permission to reproduce any abstract, contact the ARVO Office at arvo@arvo.org.

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5717/D688

Abstract Title:

Eye Bank Storage of Cultured Corneal Epithelium: Sterility Testing of Storage Media, Long-Term Preservation, and Deepithelialization of the Amniotic Membrane Substrate

Presentation Start/End Time:

Thursday, May 01, 2008, 10:45 AM -12:30 PM

Location:

Hall B/C

Reviewing Code:

151 cornea: stem cell - CO

Author Block:

S. Raeder1A, T. Paaske Utheim1A, Ø. Aass Utheim1A, M. de la Paz2, J.R. Eidet1A, T. Lyberg1B. ADept of Ophthalmology, BCenter for Clinical Research, 1Ulleval University Hospital, Oslo, Norway; 2Centro de Oftalmologia Barraquer, Barcelona, Spain.

Keywords:

482 cornea: epithelium, 483 cornea: storage, 737 transplantation

Purpose: In recent studies we have examined the feasibility of eye bank storage of cultured human limbal epithelial cells (HLEC) for transplantation. This study aimed at investigating microbiological sterility, longterm preservation, and effects of deepithelialization of the amniotic membrane substrate of cultured HLEC subject to eye bank storage.

Methods: HLEC were expanded from cadaver explants on intact amniotic membranes (iAM) or denuded amniotic membranes (dAM) for 3 weeks and stored in a closed container in organ culture medium at 23°C. Sterility of the storage medium was tested using the Bactec blood bottle method. A laser confocal microscope and digital imaging were used to distinguish live (calcein AM-positive) from dead (ethidium homodimer-1-positive) cells in HLEC cultures on iAM following 2-and 3-week OC storage. Quantitative transmission electron microscopy analysis and scanning electron microscopy was performed on HLEC cultures on iAM and dAM following 1-week storage.

Results: None of the 46 blood culture bottles (Bactec Plus Aerobic/F bottles (n=23) and Bactec Lytic/10 Anaerobic/F bottles (n=23)) were contaminated, giving a contamination rate of 0%. Basal layer viability of cultured limbal epithelial cells was 85.6% ± 13.5% (range 0.25-97%) after 2-weeks storage versus 52.7% ± 13.1% (range 0.26-81%) after 3-weeks storage (P<0.001). Following 1-week storage, the number of desmosomes per µm in HLEC cultured on iAM (1.39 ± 0.77 (range 0.49 - 2.51)) was not significantly different from HLEC cultured on dAM (0.98 ± 0.45 (range 0.02-1.37)), and scanning electron microscopy demonstrated tightly apposed superficial cells in both groups.

Conclusions: These data demonstrates that cultured HLEC may be easily controlled for microbial contamination during eye bank storage and that cultured corneal epithelium demonstrates high cell survival rates for up to 2-weeks storage. With respect to desmosomal attachments denuding of the amniotic membrane did not have any significant impact on the structural integrity of cultured HLEC following storage.

Commercial Relationship:

S. Raeder, Patent application, P; T. Paaske Utheim, Patent application, P; Ø.

Aass Utheim, None; M. de la Paz, None; J.R. Eidet, None; T. Lyberg, None.

Support:

Southern Eastern Norway Regional Health Authority

©2008, Copyright by the Association for Research in Vision and Ophthalmology, Inc., all rights reserved. Go to www.iovs.org to access the version of record. For permission to reproduce any abstract, contact the ARVO Office at arvo@arvo.org.

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5746/D717

Abstract Title:

Identification of Predilection Target Sites for Tissue Harvesting in Corneal Epithelial Tissue Engineering

Presentation Start/End Thursday, May 01, 2008, 10:45 AM -12:30 PM Time: Location:

Hall B/C

Reviewing Code:

151 cornea: stem cell - CO

Author Block:

T. Utheim1A, S. Raeder1A, O.K. Olstad1B, O. Utheim1A, M. de la Paz2, W.B. Medin3, B. Roald1C, T. Lyberg1D. ADepartment of Ophthalmology, BDepartment of Clinical Chemistry, CDepartment of Pathology, DCenter for Clinical Research, 1Ulleval University Hospital, Oslo, Norway; 2Centro de Oftalmologia Barraquer, Barcelona, Spain; 3Department of Ophthalmology, Buskerud Trust Hospital, Buskerud, Norway.

Keywords:

482 cornea: epithelium, 737 transplantation,

Purpose: The present study aimed at comparing gene expression, histology, and phenotypes of cultured human limbal epithelial cells (HLEC) for transplantation derived from four target limbal sites along the limbal circumference.

Methods: Cadaveric human corneas with research consent were obtained from the Centro de Oftalmologia Barraquer (Spain). HLEC were cultured on intact amniotic membranes for 21 days from human limbal explants of 1-clock-hour width from the superior, nasal, inferior, and temporal regions. Following RNA Qiagen extraction and purification from 5 mm trephinated disks of cultured epithelium, gene expression in cultured HLEC was determined using Affymetrix GeneChip Human 1.0 ST Array. Cultured HLEC were characterised by histological and immunophenotypical analysis.

Results: The mean RNA yield was highest in extracts from the superior regions (287.8 ng/µl) and lowest from temporal regions (86.3 ng/µl) which provided sufficient RNA for microarray analysis in only two out of four temporal biological replicates, but the differences were not statistically significant. Of the 28.869 genes tested in HLEC cultures, six genes (KRT12, KRT16, MFSD4, ZNF667, RHOU, and SILV) were differentially overexpressed (more than twofold, p<0.05, unpaired t test)) in HLEC cultures from superior limbus compared with nasal limbus and only one gene (HEPHL1) compared with inferior limbus. Three genes (PLD5, SNORD57, and BEX1) were differentially overexpressed in HLEC cultures from inferior limbus compared with cultures from nasal limbus. HLEC cultures derived from the superior region, demonstrated the highest success rate (83%, 5/6) in terms of formation of a confluent multilayered epithelium of up to seven layers thickness in sharp contrast to cultures from the temporal region that were mostly monolayered or devoid of cells. Independent of regional limbal localization, cultured HLEC demonstrated an undifferentiated nature (p63+/ΔNp63α+/ABCG2+/K19+/Vimentin+/Integrin β1+/K3-/K5+/E-Cadherin+) Conclusions: These data suggest that HLEC cultures from superior limbal biopsies most frequently succeed in the formation of multilayered epithelia. However, the differences in gene expression in HLEC cultures derived from different regions were minimal.

Commercial Relationship:

T. Utheim, Patent application, P; S. Raeder, Patent application, P; O.K. Olstad, None; O. Utheim, None; M. de la Paz, None; W.B. Medin, None; B. Roald, None; T. Lyberg, None.

Support:

Southern Eastern Norway Regional Health Authority

©2008, Copyright by the Association for Research in Vision and Ophthalmology, Inc., all rights reserved. Go to www.iovs.org to access the version of record. For permission to reproduce any abstract, contact the ARVO Office at arvo@arvo.org.

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6074/D680

Abstract Title:

A New Method for Quantifying Limbal Stem Cell Markers

Presentation Start/End Time:

Thursday, May 01, 2008, 1:00 PM - 2:45 PM

Location:

Hall B/C

Reviewing Code:

151 cornea: stem cell - CO

Author Block:

R.M. Corrales1,2, A. De la Mata2, M. Lopez2, V. Saez2, M. De la Paz3, M. Calonge2,1. 1CIBER-BBN, Valladolid, Spain; 2Ocular Surface Group, IOBA, University of Valladolid, Valladolid, Spain; 3Centro de Oftalmología Barraquer, Barcelona, Spain.

Keywords:

482 cornea: epithelium, 534 gene microarray, 480 cornea: basic science

Purpose: To analyze the expression of 84 genes related to the identification, growth, maintenance, and differentiation of stem cells using a real time reverse transcription (RT2) PCR array (The Human Stem Cell RT² Profiler™, SuperArray Bioscience Co.) in healthy adult human corneal and limbal samples.

Methods: RNA was isolated from 11 limbal and central cornea epithelial cells. cDNA was synthesized and used for a RT2 PCR array, that combines real time PCR sensitivity and specificity with the ability of microarrays to detect the expression of multiple genes simultaneously. The expression of 84 human genes related to: 1) stem cell specific markers (cell cycle regulators, chromosome and chromatin modulators, genes regulating symmetric/asymmetric cell division, self-renewal markers, cytokines and growth factors, genes regulating cell-cell communication, cell adhesion molecules and metabolic markers); 2) stem cell differentiation markers (embryonic, hematopoietic, mesenchymal and neural cell lineage markers); and 3) signalling pathways important for stem cell maintenance (Notch and Wnt pathways).The comparative Ct method was used for analyzing the results using the cornea as calibrator.

Results: RT2 PCR array indicated an up-regulation in the expression of most limbal genes compared to corneal genes. The relative fold in limbal samples was higher than 7, 4, and 3 for the 9 embryonic, 6 hematopoietic and 6 mesenchymal cell lineage markers, respectively. The highest folds were found for the following genes: CD8A:12.06, DLL3:12.10, ALPI:14.02, ABCG2:15.23, CCND2:15.43, COL1A1:21.83, IGF1:31.83, K15:87.88 and CXCL12:140.99.

Conclusions: We found new putative limbal stem cell marker genes by RT2 PCR array which require further investigation.

Commercial Relationship:

R.M. Corrales, None; A. De la Mata, None; M. Lopez, None; V. Saez, None; M. De la Paz, None; M. Calonge, None.

Support:

Ministerio de Sanidad y Consumo, Instituto de Salud Carlos III: CIBER-BBN CB06/01/0003 and Red Temática de Investigación Cooperativa en Salud. Red TerCel. Federación de Cajas de Ahorros

©2008, Copyright by the Association for Research in Vision and Ophthalmology, Inc., all rights reserved. Go to www.iovs.org to access the version of record. For permission to reproduce any abstract, contact the ARVO Office at arvo@arvo.org.

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4054

Abstract Title:

Is It Necessary to Add a Scleral Buckle When Doing a Pars Plana Vitrectomy for Primary Repair of Rhegmatogenous Retinal Detachment? The Retina 1 Project, Report 3

Presentation Start/End Time:

Wednesday, Apr 30, 2008, 12:00 PM -12:15 PM

Location:

Grand Floridian B

Reviewing Code:

325 retinal detachment - RE

Author Block:

R.M. Sanabria1, J.C. Pastor1, I. Fernández2, M. Alfaiate3, A. Navea4, J. Elizalde5, J. Rojas1, R. Fernandez-Quispe1, L. Cordoves6, E. Rodriguez de la Rua1. 1IOBA-Inst de Oftalm Aplic, University Of Valladolid, Valladolid, Spain; 2IOBA-Inst de Oftalm Aplic, Ciber BBN-IOBA University of Valladolid, Valladolid, Spain; 3Ophthalmology, Hospital Universitario de Coimbra, Coimbra, Portugal; 4Fundación Oftalmologica del Mediterraneo, Valencia, Spain; 5IOBA-Inst de Oftalm Aplic, Clinica Barraquer, Barcelona, Spain; 6Ophthalmology, Hospital Universitario de Tenerife, Tenerife, Spain.

Keywords:

694 retinal detachment, 758 vitreoretinal surgery,

Purpose: The use of a scleral buckle (SB) added to a PPV as a surgical procedure for treating rhegmatogenous retinal detachment (RD) is a matter of controversy. The use of a SB might improve the anatomical success, but it is time consuming and could be a source of complications. Retina 1 project is a prospective multicenter study in 18 centers of Spain and Portugal collecting patients with RD to improve the prediction of patients who will develop a proliferative vitreoretinopathy. Using some of the collected data, this study tries to elucidate if the addition of a SB to PPV will improve the anatomical results of surgery for RD. Methods: Prospective, non-randomized, interventional comparative study with data from consecutively treated RD from January 2005 to May 2007. Cases with pre-operative PVR grade C-1 or higher and perforating trauma were excluded. Minimum follow-up was 3 months. Surgeons were free to choose the surgical technique they considered more appropriate. Only patients that underwent primary pars plana vitrectomy were included. Logistic regression models were used to evaluate the relationship between preand intra- surgical variables and anatomical success.

Results: Data from 514 RD in phakic and pseudophakic patients were analysed. Group 1 had 245 patients treated only with PPV and Group 2 had 269 patients treated with SB and PPV. Global anatomic success rate after a single procedure was 89.88% without differences between both groups. Surgeons decided to use VPP plus SB more frequently in RD on phakic patients, when multiple, posterior o no breaks were identified, in case of posterior vitreous attachment and more extended RD. Logistic regression analysis showed that adding a SB to PPV did not improve the anatomical results in any of the clinical categories above mentioned. Moreover, phakic patients with posterior vitreous detachment, had a statistically better anatomical results in group 1.

Conclusions: Our data do not support the benefits, in terms of anatomical success, of adding a SB to a PPV in any specific group of patients for primary repair of rhegmatogenous RD. Commercial Relationship:

R.M. Sanabria, None; J.C. Pastor, None; I. Fernández, None; M. Alfaiate, None; A. Navea, None; J. Elizalde, None; J. Rojas, None; R. Fernandez-Quispe, None; L. Cordoves, None; E. Rodriguez de la Rua, None.

Support:

None

©2008, Copyright by the Association for Research in Vision and Ophthalmology, Inc., all rights reserved. Go to www.iovs.org to access the version of record. For permission to reproduce any abstract, contact the ARVO Office at arvo@arvo.org.

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Càtedra de Recerca en Oftalmologia "Joaquim Barraquer" - UAB

The Accommodation Club 6th Meeting 2 May 2008 • Retter Auditorium • Bascom Palmer Eye Institute • Miami, FL USA President: Jean-Marie Parel, Univ. of Miami (USA) Secretary: Arthur Ho, Institute for Eye Research (Australia) Chevalier: Joaquin Barraquer, Eduard Haefliger, Tsutomu Hara, Okihiro Nishi, Philippe Sourdille, Rafael, Barraquer, Franck L Villain, Yoshiko Takesue, Hans-Joachim Hettlich, Robert Stegman, Sonia Yoo, Fabrice Manns, Adrian Glasser, Ronald R Krueger, Arlene Gwon, Mary Anne Croft, Thom Terwee PAPER TITLE: How could cortical cataracts be induced by accommodation forces?

AUTHORS: Ralph Michael, Institut Universitari Barraquer, Barcelona, Spain Rafael I. Barraquer, Institut Universitari Barraquer, Barcelona, Spain Gijs F.J.M. Vrensen, Leiden University Medical Center, University of Leiden, The Netherlands ABSTRACT: We evaluated the gross morphology, location, and fiber cell architecture of equatorial cortical opacities in the aging human lens. Using dark-field stereomicroscopy, we photographed donor lenses in toto and as thick slices. In addition, we investigated the details of the fiber cell architecture using fluorescent staining for membranes and by scanning electron microscopy. We then combined our data with data from recent studies on lens viscoelasticity, biochemistry and Scheimpflug imaging. We found that small cortical and cuneiform opacities are accompanied by changes in fiber structure and architecture mainly in the equatorial border zone between the lens nucleus and cortex. Because the lens cortex and nucleus have different viscoelastic properties in young and old lenses, we hypothesize that external forces during accommodation cause shear stress predominantly in this border zone. Evaluation of Scheimpflug images during accommodation by Dubbelman and co-workers also revealed a sudden change in stretch at the transition between anterior cortex and nucleus. The location of the described changes suggests that these mechanical forces may cause fiber disorganization, small cortical opacities, and, ultimately, cuneiform cataracts. Our hypothesis would be in line with recent findings by Truscott and co-workers about a two-compartmental organization of the human lens. They found biochemical arguments for a transport barrier developing at a middle age at the cortical/nuclear interface.

40

Càtedra de Recerca en Oftalmologia "Joaquim Barraquer" - UAB

114ème CONGRES DE LA SOCIETE FRANCAISE D'OPHTALMOLOGIE Du Samedi 10 au Mercredi 14 Mai 2008 Palais des Congrès, 2 Place de la Porte Maillot 75017 Paris Symposium SFO-EVER 2008 Modérateurs : B. BODAGHI (Paris) et L. DESJARDINS (Paris) 14h

Introduction : G. SOUBRANE (Paris)

Table ronde Tumeurs oculaires (Mélanomes oculaires) 14H05-14H15 Mélanome conjonctival : une tumeur oculaire dont la fréquence est en augmentation. TERO KIVELÄ, SEPPO TUOMAALA (Helsinki, Finlande) 14h16-14h26 Identification d’une signature génomique de haut risque métastatique du mélanome uvéal. L. DESJARDINS, J TROLET, P. HUPÉ, I. LEBIGOT, P. MARIANI, C. PLANCHER, B. ASSELAIN, X. SASTRE-GARAU, S. SAULE, S. PIPERNO-NEUMANN, E. BARILLOT , J. COUTURIER (Paris) 14h27-14h37 Analyse cytogénétique des mélanomes : F. MOURIAUX (Caen) 14h38-14h45 Techniques de biopsie des mélanomes de l’uvée pour analyse cytogénétique J. ELIZALDE, R. MICHAEL, RI BARRAQUER (Barcelone, Espagne) 14h46-14h53 Taux de survie actuel après énucléation primaire pour mélanome de la choroïde : L. KODJIKIAN, J. GAMBRELLE, M. DEVOUASSOUX SHISHEBORAN, L. G. BAGGETTO, B. JEAN-LOUIS, J. FLEURY, J. D. GRANGE (Lyon)

41

Càtedra de Recerca en Oftalmologia "Joaquim Barraquer" - UAB

European Association for Vision and Eye Research

Desde el departamento de investigación se han organizado dos Special Interest Symposium, uno sobre la medición de luz dispersa en el ojo y otro sobre nuevas lentes intraoculares y un total de cinco ponencias.

42

EVER

Página 1 de 1

European Association for Vision and Eye Research LC: Straylight as quality measure for ophthalmic procedures Often patients complain about halos, glare, hazy vision and blinding at night, but while doing regular tests like visual acuity, contrast sensitivity and slit lamp examination nothing unusual can be found. Most probably, the patient’s complaints are caused by increased light scattering in the eye media which can not be detected by common tests. Our SIS will discuss the measurement of ocular straylight in general and straylight caused by changes in the cornea and lens, including intraocular lenses.

Session type Special Interest Symposium Moderators for this session Ralph MICHAEL, Tom VAN DEN BERG Time and place of session This session will take place on Thursday 2 October 2008 from 08:15 till 09:45 in room Emerald II. Abstracts assigned to this session (6) 08:15

15'

4141

Introduction to straylight as quality measure for ophthalmic procedures

VAN DEN BERG TJTP

08:30

15'

4142

Scattered Light and Visual Acuity after Descemet-Stripping with Endothelial Keratoplasty

MCLAREN JW, BOURNE WM, PATEL SV

08:45

15'

4143

In-vitro characterisation of corneal scatter in rabbit corneas following PRK

GINIS H, DE BROUWERE D, PENTARI I, PALLIKARIS I

09:00

15'

4144

Glare test as indicator for cataract surgery

TASSIGNON MJ, ROZEMA JJ

09:15

15'

4145

Pseudophakic dysphotopsia Counting the stars

ASLAM T, ASPINALL P

09:30

15'

4146

Reliability results of straylight measurements using the C-Quant

CERVINO A, MONTESMICO R, FERRERBLASCO T

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30.06.2008

EVER

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European Association for Vision and Eye Research COS: Corneal grafting 1 Session type Free papers Moderators for this session Philippe KESTELYN, Jean-Jacques GICQUEL Time and place of session This session will take place on Friday 3 October 2008 from 14:15 till 15:45 in room Emerald I. Abstracts assigned to this session (5) 14:15

12'

5331

Selection and assessment of vital dyes to improve the endothelial quality control of organ cultured corneas

THURET G, DUBAND S, CAMPOLMI N, PIPPARELLI A, PISELLI S, DUMOLLARD JM, PEOC'H M, ACQUART S, GARRAUD O, GAIN P

14:27

12'

5332

Sclerocorneal limbus transplantation

BARRAQUER J

14:39

12'

5333

Long term results of Limbal stem cell transplantation in ocular surface disease

MIRI A, ALDEIRI B, MATHEW M

14:51

12'

5334

Quality of vision following penetrating keratoplasty and deep anterior lamellar keratoplasty for keratoconus.

PARENTE G, FONTANA L, TASSINARI G

15:03

12'

5335

Impact of culturing on metabolic profile of human corneas

KRYCZKA T, EHLERS N, MIDELFART A

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30.06.2008

EVER

PĂĄgina 1 de 2

European Association for Vision and Eye Research e5332 - Sclerocorneal limbus transplantation Print this page Topics Cornea - Clinical sciences - Surgery Additional information Oral presentation Session information This abstract has been assigned to session Corneal grafting 1.

This session will take place on Friday 3 October 2008 from 14:15 till 15:45 in room Emerald I. Authors Author 1

BARRAQUER J Instituto Barraquer (Barcelona)

Abstract Discussion of the evolution of a technique suggested by JosĂŠ I. Barraquer in 1947, later completed by Strampelli and adopted and modified by other corneal surgeons.

The original procedure was based on the clinical observation that regeneration of the corneal epithelial cells is dependant on the state of the limbus. This explained the bad Purpose prognosis of chemical burns and severe limbus trauma. At present it is well known that the stem cells located in the corneal limbus are responsible for epithelial regeneration. Penetrating keratoplasty limited to the cornea does not supply stem cells.

The technique consists in obtaining and grafting limbus tissue, in form of an annular or partial conjunctivosclerocorneal limbal graft preferably from the fellow eye or a living donor, or an eye bank eye. A case of chemical burn operated in 1981 is presented to illustrate the original technique of Strampelli. To illustrate the modern Methods approach a case of chemical trauma with superior and inferior symblepharon and total vascularized leucoma operated in 1999 (limbal donor graft)taking advantage of the modern advances available at present (improved instrumentation, pharmacological inhibition of homograft reaction)is shown.

The results were encouraging.The patient operated in 1981 died in 1988 with good vision (0.6).In the case operated in 1999, three months after the limbal transplant, reResults epithelization of the cornea was correct and an 8 mm penetrating keratoplasty combined with cataract extraction and IOL implantation was performed. Corrected vision 5 years postoperatively was 0.35.

Modern investigation and technology have converted a procedure based on surgical Conclusionsinspiration more than half a century ago into a valuable option in cases of irreversible damage of the corneal limbus.

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30.06.2008

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European Association for Vision and Eye Research LC: Lens and cataract Session type Free papers Moderators for this session Jan-Olof KARLSSON, Alfred WEGENER Time and place of session This session will take place on Friday 3 October 2008 from 17:45 till 19:15 in room Emerald II. Abstracts assigned to this session (6) 17:45

12'

5441

Morphological link between accommodation, presbyopia and cortical cataract

MICHAEL R, BARRAQUER RI, VRENSEN G

17:57

12'

5442

The Time of Onset of Inherited Cataract.

BRON AJ, HANNAN F, MUSHTAQ B, KORETZ JF

18:09

12'

5443

Acute effects of the sigmareceptor agonist on human len epithelial cells

KARLSSON JO, JONHEDE S, PETERSEN A, ZETTERBERG M

18:21

12'

5444

In vivo high power infrared radiation exposure time dependence of lens light scattering

AL-SAQRY R, GALICHANIN K, LI Y, SÖDERBERG PG, SCHULMEISTER K, HUSINSKI J, BUCHT C

18:33

12'

5445

In Vivo Assessment of Blue Light Attenuation of the Crystalline Lens and Tinted and Not Tinted Intraocular Lenses

KONTADAKIS GA, TSIKA CI, PLAINIS S, MAKRIDAKI M, MOSCHANDREAS I, TSILIMBARIS MK

18:45

12'

5446

Comparison of parameters in cataract surgery between coaxial microincision and standard coaxial incision.

GEORGET M, CARDON A, FAVARD A, CONTOUR S, ABID M, PISELLA PJ

Terms of use - Privacy policy EVER Office - European Association for Vision and Eye Research Kapucijnenvoer 33, B-3000 Leuven, Belgium ever@ever.be • tel +32 16 233 849 • fax +32 16 234 097

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European Association for Vision and Eye Research e5441 - Morphological link between accommodation, presbyopia and cortical cataract Print this page Topics Lens - Clinical sciences - Morphology Additional information Oral presentation Session information This abstract has been assigned to session Lens and cataract.

This session will take place on Friday 3 October 2008 from 17:45 till 19:15 in room Emerald II. Authors MICHAEL R Institut Universitari Barraquer (Barcelona) BARRAQUER RI Author 2 Institut Universitari Barraquer (Barcelona) VRENSEN G Author 3 Leiden University Medical Center, University of Leiden (Leiden) Abstract Evaluation of the gross morphology, the cortical location and the fiber cell Purpose architecture of cortical opacities in the aging human lens.

39 human donor lenses were photographed in toto in frontal view using dark-field stereomicroscopy. 15 lenses were fixed, cut in axial slices and photographed the Methods same way. Details of fiber cell architecture were investigated by fluorescent staining for membranes and by scanning electron microscopy.

Small focal and cuneiform cortical cataracts are discrete opacities located at a specific depth below the capsule, and extending from the equatorial region in anterior and posterior direction. A sharp border is observed, between the opacities with their disorganized fiber architecture and the deeper nuclear layers, which show a regular fiber pattern. This border is at a mean depth of 700 Âľm below the capsular Results surface. Close examination of the opacities revealed fiber folds, fiber undulations, fiber-to-fiber separations, fiber breaks, water lakes and fiber displacement. Because the lens cortex and nucleus have different viscoelastic properties in young and old lenses, we hypothesize that external forces during accommodation cause shear stress predominantly in this border zone.

The location of the described changes suggests that mechanical forces may cause fiber disorganization, small cortical opacities, and, ultimately, cuneiform cataracts.

Our hypothesis would be in line with recent findings by Truscott and co-workers Conclusions about a two-compartmental organization of the human lens. They found biochemical arguments for a transport barrier developing at a middle age at the cortical/nuclear interface.

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http://www.ever.be/view_abstract.php?abs_id=3877

30.06.2008

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European Association for Vision and Eye Research LC: New IOL technology - restoring accommodation There is much talk about yellow filtration, asphericity, multifocality, accommodation (focusshift) and adjustable IOLs. We have assembled a panel of scientists and clinicians to explain in clear language what is fact and what is hype, as well as to predict future developments in these areas.

Session type Special Interest Symposium Moderators for this session Rafael I. BARRAQUER, Ralph MICHAEL Time and place of session This session will take place on Saturday 4 October 2008 from 08:15 till 09:45 in room Emerald II. Abstracts assigned to this session (5) 08:15

18'

6141

Multifocality and focus shift IOLs - theoretical aspects

HULL CC

08:33

18'

6142

Clinical use of multifocal and focus shift IOLs

BARRAQUER RI, MICHAEL R

08:51

18'

6143

Straylight effects in diffractive multifocal IOL compared to monofocal IOL

NUIJTS RMMA, FRANSSEN L, DE VRIES NE, TJIA KF, VAN DEN BERG TJTP

09:09

18'

6144

Visiogen Synchrony dual-optic lens

AUFFARTH GU

09:27

18'

6145

Innovative IOL accommodative technologies: NuLens and TekClear

ALIO SANZ JL, BEN-NUN J

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European Association for Vision and Eye Research e6142 - Clinical use of multifocal and focus shift IOLs Print this page Topics Lens - Clinical sciences - Surgery Additional information Session information This abstract has been assigned to session New IOL technology - restoring accommodation.

This session will take place on Saturday 4 October 2008 from 08:15 till 09:45 in room Emerald II. Authors BARRAQUER RI Institut Universitari Barraquer - UAB (Barcelona) MICHAEL R Author 2 Institut Universitari Barraquer - UAB (Barcelona) Abstract To compare the clinical experience with multifocal and focus shift IOLs in Austria, Purpose Germany and Spain.

We give a summary of published and unpublished data, reviews and meta-analyses.

Main outcome measures are uncorrected distance and near visual acuity, and reading speed under different light conditions as well as subjective patient satisfaction and Methods spectacle independence. The focus will be on ReStor, ReZoom and Technis IOLs in the multifocal group, and ICU, BioComFold, AT-45 Crystalens in the focus shift group.

Multifocal IOLs can provide functional intermediate vision in bright light; under dim light the results vary depending on the IOL design. Hybrid design of the refractivediffractive IOL can reduce the increased optical aberrations induced by purely Results refractive multifocal IOLs. Aspheric apodized diffractive IOLs can reduce stray light artefacts and can enhance distance vision performance for large pupils. Focus shift IOLs result in a moderate to no improvement for uncorrected near visual acuity and minor or no forward movement, on average corresponding to less than 0.5 diopters.

Multifocal IOLs provide pseudo-accommodation and their optical quality has improved due to new design developments. Focus shift IOLs accommodate only by a Conclusions minor amount abd give some pseudo-accommodation by mechanisms not clearly understood.

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EVER Office - European Association for Vision and Eye Research Kapucijnenvoer 33, B-3000 Leuven, Belgium ever@ever.be • tel +32 16 233 849 • fax +32 16 234 097

http://www.ever.be/view_abstract.php?abs_id=3872

30.06.2008

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European Association for Vision and Eye Research LC: New IOL technology - new modalities There is much talk about yellow filtration, asphericity, multifocality, accommodation (focusshift) and adjustable IOLs. We have assembled a panel of scientists and clinicians to explain in clear language what is fact and what is hype, as well as to predict future developments in these areas.

Session type Special Interest Symposium Moderators for this session Per SÖDERBERG, Christopher LIU Time and place of session This session will take place on Saturday 4 October 2008 from 11:30 till 13:00 in room Emerald II. Abstracts assigned to this session (5) 11:30

18'

6241

IOL filters, is there an optimal absorption?

SÖDERBERG PG, ZOEGA G

11:48

18'

6242

Aspheric optics, theoretical considerations

UNSBO P

12:06

18'

6243

Clinical experience in aspheric IOLs - a review of the world literature

LIU C

12:24

18'

6244

Purkinje based IOL centration

TASSIGNON MJ

12:42

18'

6245

Long-term results of cataract surgery with implantation of a mechanically, reversibly adjustable intraocular lens: *Acri.Tec AR-1 PC/IOL

JAHN CE, STEFIKOVA K

Terms of use - Privacy policy EVER Office - European Association for Vision and Eye Research Kapucijnenvoer 33, B-3000 Leuven, Belgium ever@ever.be • tel +32 16 233 849 • fax +32 16 234 097

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30.06.2008

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European Association for Vision and Eye Research COS: Keratoprostheses Session type Special Interest Symposium Moderator for this session Christopher LIU Time and place of session This session will take place on Saturday 4 October 2008 from 14:15 till 15:45 in room Emerald I. Abstracts assigned to this session (5) 14:15

18'

6331

The narrowing choice of keratoprostheses

LIU C

14:33

18'

6332

Developing a Recovery Psychological Model for patients undergoing KPro surgery

BUSUTTIL A, LIU C

14:51

18'

6333

More than 50 years of experience with keratoprostheses

BARRAQUER J

15:09

18'

6334

Boston KPro experience in Barcelona

DE LA PAZ M, ALVAREZ DE TOLEDO J, MICHAEL R, BARRAQUER R, BARRAQUER J

15:27

18'

6335

Biosynthetic corneas - an update

FAGERHOLM P, LAGALI N, GRIFFITH M

Terms of use - Privacy policy EVER Office - European Association for Vision and Eye Research Kapucijnenvoer 33, B-3000 Leuven, Belgium ever@ever.be • tel +32 16 233 849 • fax +32 16 234 097

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European Association for Vision and Eye Research e6333 - More than 50 years of experience with keratoprostheses Print this page Additional information Session information This abstract has been assigned to session Keratoprostheses.

This session will take place on Saturday 4 October 2008 from 14:15 till 15:45 in room Emerald I. Authors Author 1

BARRAQUER J Instituto Barraquer (Barcelona)

Abstract

Purpose

We started to use acrylic corneal prostheses experimentally in 1955, principally in eyes considered functionally lost or after several attempts of other keratoplastic procedures had failed. In our first 15 cases a Dorzee prosthesis or a modified Dorzee prosthesis (Barraquer-Cardona) had been used, in three cases some useful vision was obtained for several months or even up to 4 years. However, the expulsion rate was high, mainly due to the lysis of the corneal borders around the prosthesis. The communication of Strampelli’s first technique of osteo-odonto-keratoprosthesis, using a “live” support encouraged us to continue our experimentation. A case of bilateral blindness in a 50 year old patient, due to mine explosion in 1941 (Second World War) was first seen in 1965, 25 years after the accident. The right eye was lost due to retinal detachment, the left eye was aphakic, with opaque cornea due to explosion impacts and anterior synechiae due to old perforations. In 1965 osteoodonto-keratoprosthesis, using Strampelli’s first technique, was performed with good recuperation of vision (0.4) for 10 years. Different aspects and details of the case are presented and commented. Unfortunately in 1975 necrosis of the bone support developed and reconstructive keratoplasty had to be performed. The patient remained with very low visual acuity (0.03) and a very reduced visual field. The author considers that this result, obtained with the very limited facilities available more than 40 years ago, confirms and justifies that experimentation in this field must continue, making use of all technological, surgical, pharmacological and research facilities available today.

Methods Results Conclusions Terms of use - Privacy policy EVER Office - European Association for Vision and Eye Research Kapucijnenvoer 33, B-3000 Leuven, Belgium ever@ever.be • tel +32 16 233 849 • fax +32 16 234 097

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European Association for Vision and Eye Research e6334 - Boston KPro experience in Barcelona Print this page Additional information Session information This abstract has been assigned to session Keratoprostheses.

This session will take place on Saturday 4 October 2008 from 14:15 till 15:45 in room Emerald I. Authors DE LA PAZ M Instituto Barraquer (Barcelona) ALVAREZ DE TOLEDO J Author 2 Instituto Barraquer (Barcelona) MICHAEL R Author 3 Instituto Barraquer (Barcelona) BARRAQUER R Author 4 Instituto Barraquer (Barcelona) BARRAQUER J Author 5 Instituto Barraquer (Barcelona) Abstract To describe the indications, intraoperative complications, post-operative Purpose complications and anatomical and functional results of Type I Boston keratoprosthesis at our eye center in Barcelona.

Retrospective interventional case series on 24 eyes of 22 patients who underwent Methods Boston keratoprosthesis implant from May 2006 to May 2008.

The main indication for Boston keratoprosthesis implantation was a repeated failed graft (mean = 2.33 previous grafts). The most common principal pathologies were: bullous keratopathy, herpetic keratitis, aniridic keratopathy, corneal ectasia, calcific band keratopathy. No major intraoperative complications were noted and average time of surgery was 47 minutes. The mean follow-up time was 7.42 months. The Results major post-operative complications encountered were retroprosthetic membrane in 2 eyes, endophthalmitis in 2 eyes and corneal graft melting in 1 eye. The mean best corrected visual acuity improved from 0.015 pre-operatively to 0.1 post-operatively.

Only one case of extrusion due to melting was encountered which was resolved by a reimplantation of the keratoprosthesis.

Our short-term experience with the type I Boston Keratoprosthesis is a good Conclusionsalternative for patients with repeated graft failures. Improvement in visual acuity is immediate and only minor complications were encountered.

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http://www.ever.be/view_abstract.php?abs_id=4346

30.06.2008

Càtedra de Recerca en Oftalmologia "Joaquim Barraquer" - UAB

I Jornada de Investigación (I+D+i) en Oftalmología Instituto Clínic de Oftalmología, Hospital Clínic de Barcelona Facultad de Medicina, Universidad de Barcelona Coordinación: Ricardo Casaroli & Alfredo Adán 10 de octubre de 2008 Acadèmia de Ciències Mèdiques de Catalunya i Balears, Barcelona.

8:45 Estudio coste-benefício de los métodos de criopreservación para la membrana amniótica con aplicación terapéutica.

Ricardo Casaroli, Eva Martínez Conesa, Elba Agustí, Nausica Otero, Alfredo Adán, Esteve Trías, Blanca Miranda.

9:00 Avances en la terapia tópica de la patología asociada a la superficie ocular.

Maite Sáinz de la Maza.

9:15 Aplicación de las células progenitoras mesenquimales del tejido adulto en medicina regenerativa de la superficie ocular.

Eva Martínez-Conesa, Nausica Otero, Alfredo Adán, Esteve Trías, Manuel Reina, Ricardo Casaroli.

9:30 La activación de Rac1 por PDGF y el control de la presión intraocular.

Emilio Syriani, Miguel Morales, Arcadi Gual, Jesús Pintor, Xavier Gasull.

9:45 Dinucleosidos polifosfatos y glaucoma.

Marta Castany, Jesús Pintor, Miguel Morales, Isabel Jordi, Jaume Català, Xavier Gasull.

10:00 Control de la presión intraocular mediada por la profilina.

Miguel Morales, Emilio Syriani, Azucena Gomez-Cabrero, Arcadi Gual, Jesús Pintor, Xavier Gasull.

10:15 Estudio mutacional de los genes MYOC y CYP1B1 en familias afectas de glaucoma e hipertensión ocular.

Elena Millà, Susana Duch, Miguel Carballo.

10:30 Resección en cuña para astigmatismo elevado en queratoplastia penetrante para queratocono: Cambios refractivos e histopatológicos.

María de la Paz, Ralph Michael, Rafael I. Barraquer.

10:45 Cálculo de la sensibilidad al contraste neural a partir de la medición de sensibilidad al contraste total y de la Función de Modulación de Tranferencia.

Osvaldo Guevara-Chavarría, Ralph Michael, Fernado Castanera de Molina, Rafael I. Barraquer.

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Càtedra de Recerca en Oftalmologia "Joaquim Barraquer" - UAB

11:00 Relación entre acomodación, presbiopía y catarata cortical.

Ralph Michael, Gijs Vrensen, Rafael I. Barraquer 11:15 Nuevas tecnologías para el análisis genético en patología oftálmica.

Lluís Armengol 12:00 Restauración de la acomodación en pacientes con presbiopía - Estado actual de Phaco Ersatz.

Rafael I. Barraquer, Ralph Michael.

12:15 Evaluación de las lentes intraoculares para ojo fáquico de fijación iridiana Verisyse® y Artiflex® durante la acomodación mediante tomografía de coherencia óptica de segmento anterior.

Mercè Morral, Jose L. Güell.

12:30 Lente intraocular ajustable por la luz Calhoun®: ajustes esféricos y/o tóricos en 40 ojos intervenidos de cataratas.

José L. Güell, Mercè Morral, Felicidad Manero.

12:45 Eficacia del tratamiento con infliximab en pacientres con uveitis refractarias.

Alfredo Adán, Juan J. Molina, María V. Hernández, Santiago Ortiz, Gerard Espinosa, Raimón Sanmartí, Ricardo Casaroli.

13:00 Síndrome metabólico, insulinoresistencia y edema macular diabético en pacientes diabéticos tipo II. Miguel A. Zapata, Josep Badal, Alex Fonollosa, Anna Boixadera, José García Arumí.

13:15 Aplicación de terapia combinada para el tratamiento de la proliferación angiomatosa retiniana (RAP): estudio prospectivo randomizado.

Jaume Crespí, José A. Buil, Francisca Bassaganyas.

13:30 IL-8 (Interleucina-8) y MCP-1 (Monocyte chemoattractant protein-1) en el vítreo de pacientes con edema macular secundario a oclusiones venosas retinianas.

Alex Fonollosa, Paula Fernández, Rosa M. Segura, Esther Santos, Carme Macià, Rafael Rodríguez-Infante, Miguel A. Zapata, José García-Arumí.

13:45 Novedades en el tratamiento de la neovascularización coroidea asociada a miopía patológica.

Lluís Arias, Octavi Pujol, Marc Rubio, Josep M. Caminal, Jaume Català, Jordi Arruga.

14:00 Diagnóstico genético de las distrofias de la retina. Benefícios y retos a corto y largo plazo.

Roser González

55