2010 memoria

Càtedra de Recerca en Oftalmologia "Joaquim Barraquer" - UAB

MEMÒRIA ANUAL Exercici 2010

Càtedra de Recerca en Oftalmologia "Joaquim Barraquer" - UAB

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

LÍNEAS DE INVESTIGACIÓN EN DESARROLLO ..........................5 1.1 Proyecto Phaco Ersatz ......................................................................................... 5 1.1.1 Aparato para simular la acomodación ex vivo ................................................................. 5 1.1.2 Medición de la elasticidad de las zónulas del cristalino .................................................. 6 1.2 Calidad óptica del ojo........................................................................................... 7 1.2.1 Medición de la calidad de visión en pacientes post LASIK........................................... 7 1.2.2 Medición de la luz dispersa en conductores españoles................................................... 8 1.2.3 Opacificación de la cápsula y capsulotomía YAG........................................................... 9 1.3 Diagnóstico y tratamiento del queratocono .......................................................10 1.3.1 Resección en cuña .............................................................................................................. 10 1.3.2 Anillos intraestromales ...................................................................................................... 11 1.3.3 Biomecánica de la córnea.................................................................................................. 12 1.4 Queratoprótesis y cultivo de células limbales.....................................................13 1.4.1 Estudio con electrofisología ............................................................................................. 13 1.4.2 Cultivo de células limbales ................................................................................................ 14

2. ACTIVIDADES DOCENTES ............................................................... 16 2.1 Tesis de doctorado en desarrollo ........................................................................16 2.2 Tesis de doctorado presentada en 2010...............................................................18 2.3 Trabajos de investigación Máster .......................................................................19 2.4 Formación y cursos ............................................................................................ 23 2.4.1 Curso de Estadística........................................................................................................... 23 2.4.2 Transparency Club Meetings ............................................................................................ 24

3. ACTIVIDADES EN ORGANIZACIONES CIENTÍFICAS ................26 3.1 3.2 3.3 3.4

European Association for Vision and Eye Research ......................................... 26 Acta Ophthalmologica ....................................................................................... 26 European Vision Institute - Clincal Trials......................................................... 27 Redes Temáticas de Investigación Cooperativa.................................................31

4. PUBLICACIONES ................................................................................33 4.1 4.2

Publicaciones en revistas ................................................................................... 33 Presentaciones en congresos internacionales.................................................... 35

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Càtedra de Recerca en Oftalmologia "Joaquim Barraquer" - UAB

Presentació És un motiu de satisfacció poder-vos presentar un any més la memòria anual de les activitats de la Càtedra de Recerca en Oftalmologia “Joaquim Barraquer” tant pel que fa a projectes de recerca en desenvolupament com a publicacions i activitats docents que s’han dut a terme durant l’any 2010.

Aquest any 2010 s’ha celebrat el 10è aniversari de la Càtedra, la qual va ser fundada el novembre de 2000 al si de la Universitat Autònoma de Barcelona, com la unió de dues institucions destacades en la investigació bàsica i clínica, per donar lloc a un important bastió de la investigació oftalmològica al nostre país.

D’aquesta manera el Centre d’Oftalmologia Barraquer accedeix als seus propis programes d’investigació i col·labora també amb les institucions més prestigioses a nivell nacional i internacional, com el Instituto de Salud Carlos III (RETICS y FIS), i recolza la indústria farmacèutica en la recerca de teràpies noves i més efectives, havent estat acreditada la seva tasca en aquest sentit per l’exclusiu European Vision Institute, el qual ha emès un nou certificat per al Centre vàlid des de maig de 2010 fins a abril de 2012.

Aquesta memòria també resumeix les nostres presentacions als congressos internacionals més rellevants en oftalmologia, com the World Ophthalmology Congress, the Association for Research in Vision and Ophthalmology i the European Association for Vision and Eye Research.

Pel que fa a les publicacions, voldríem esmentar que s’han publicat 10 treballs en les revistes més importants en l’àmbit de l’oftalmologia a nivell internacional, en 4 de les quals figurem com a primers autors.

En l’àmbit de formació cal destacar la realització d’un curs d’estadística per als oftàlmolegs col·laboradors i residents del Centre d’Oftalmologia Barraquer, on es van donar a conèixer els elements avui en dia més importants pel que fa a disseny d’estudis i estadística.

Els presentem aquesta memòria no només amb la satisfacció de l’objectiu assolit sinó amb el repte de plantejar noves metes.

Dr. Rafael I. Barraquer Titular de la Càtedra 10. III. 2011

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Càtedra de Recerca en Oftalmologia "Joaquim Barraquer" - UAB

Departamento de Investigación 2010

Rafael I. Barraquer, Ralph Michael

Gustavo Montenegro, Kelma Macedo, Ralph Michael, Carlos Gordillo

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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, Rodolfo Carretié, Carlos H. Gordillo, 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 cual 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.

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Càtedra de Recerca en Oftalmologia "Joaquim Barraquer" - UAB

1.1.2 Medición de la elasticidad de las zónulas del cristalino Ex vivo measurements of zonular elastic properties as a function of age in a computer controlled device for simulation of accommodation Ralph Michael, Marek Mikielewicz, Carlos H. Gordillo, Rafael I. Barraquer Institut Universitari Barraquer, Barcelona Purpose To measure the elastic properties of the human lens zonules.

Methods Based on previous designs by Fisher, Glasser, Campbell and Parel our device consists of a rigid bench for holding and stretching coronal eye sections including the ciliary-lens zone.

Circumferential radial stretching is created by a stepper motor coupled to a digital outside micrometer for linear displacement and distance measurement, and a digital balance for load measuring. This is attached to the specimen through 8 Prolene sutures. One web cam is placed above to monitor the coronary diameter changes. We measured six presbyopic eyes from human donors ageing 60, 70, 73, 73, 83 and 89 years.

Results Preliminary results showed that zonular elongation by 500 µm produced a load of about 10 mN and 1000 µm of about 23 mN, relatively independent of age. Zonular elongation by 2000 µm yielded a load of 80 mN at 60 years and decreased with age to 55 mN at 89 years. Exact stressstrain calculations are under preparation. (10 mN = 1.02 g)

Conclusions Under physiological conditions, the elastic properties of the zonular apparatus appear not to change with age. However, with extreme elongation, we found a decrease with age.

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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, PhD; Gustavo A. Montenegro, MD; Rafael I. Barraquer, MD, PhD Institut Universitari Barraquer, Universitat Autònoma de Barcelona, Barcelona, Spain 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 3.5 to -8.0 D) were treated for LASIK with Bausch & Lomb Technolas Z100 and studied pre-op and two-month 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).

RESULTS: Pre-op mean straylight parameter did not change at two months post-op. Only one eye out of 46 had straylight values increased by more than 0.25 log units. There was no significant change in contrast sensitivity at all four spatial frequencies. We found a significant improvement of post-op contrast sensitivity when we excluded 10 eyes that presented variations of two or more positions in contrast sensitivity.

CONCLUSION: Mean straylight and contrast sensitivity did not change two months after LASIK. Both visual quality measures worsened in a few cases but remained constant or improved slightly in the majority of the cases.

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Càtedra de Recerca en Oftalmologia "Joaquim Barraquer" - UAB

1.2.2 Medición de la luz dispersa en conductores españoles Intraocular straylight screening in medical testing centres for driver licence holders in Spain Ralph Michael1, Rafael I. Barraquer1, Judith Rodríguez2, Josep Tuñi i Picado3, Joan Serra Jubal3, Juan Carlos González Luque4, Tom van den Berg5 1 Institut Universitari Barraquer, Universitat Autònoma de Barcelona, Barcelona, Spain 2 Centro Medico Univeristas, Zaragoza, Spain 3 CREME federación, Barcelona, Spain 4 Observatorio Nacional de Seguridad Vial, Dirección General de Tráfico, Madrid, Spain 5 Netherlands Institute for Neuroscience, Royal Academy, Amsterdam, The Netherlands PURPOSE: To test the performance of the C-quant straylight meter during the daily routine work in medical testing centres for driver license applicants and driver license holders in Spain.

METHODS: Altogether 914 subjects, of which 376 younger than 35 years, 428 between 35 and 60 years and 110 over 60 years were measured with the C-quant in three medical testing centres (Barcelona, Zaragoza and Palma de Mallorca) in 2006. Technicians were instructed once and the measurements were done during the daily routine work. We recorded: age, BCVA, self-reported subjective blinding at night; and from the C-quant: straylight parameter (log s), measurement quality parameters (ESD, Q) and test duration.

RESULTS: Total C-quant test duration increases slightly with age from a mean of 7 min (<35 years) to a mean of 9 min (>60). At first attempt, 82% of all subjects produced reliable results (ESD < 0.12). The straylight parameter for this group was independent of ESD and ESD was independent of total test duration. The known age dependence of the straylight parameter and the weak correlation with BCVA was confirmed. The distribution of subjective blinding at night was very different between test centres. Subjects with "very strong" subjective blinding had significantly higher straylight values than subjects with "no" subjective blinding. Subjects avoiding night driving had significant higher straylight values than subjects driving at night.

CONCLUSION: The C-quant measure is reasonable fast. Good subject instruction is important to get first attempt reliable results. Self-reported subjective blinding results depend strongly on the interviewer.

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Càtedra de Recerca en Oftalmologia "Joaquim Barraquer" - UAB

1.2.3 Opacificación de la cápsula y capsulotomía YAG Posterior capsule opacification assessment and factors that influence visual quality after posterior capsulotomy Gustavo A. Montenegro,1 Patrick Marvan,2 Alois Dexl,2 Andrés Picó,3 María Isabel Canut,3 Günther Grabner,2 Rafael I. Barraquer,1,3 Ralph Michael1 1 Institut Universitari Barraquer, Universitat Autònoma de Barcelona, Barcelona, Spain 2 University Eye Clinic, Paracelsus Medical University, Salzburg, Austria 3 Centro de Oftalmología Barraquer, Barcelona, Spain Purpose: To study the correlation between posterior capsule opacification (PCO) and intraocular straylight and visual acuity.

Design: Prospective non-interventional study.

Methods: We measured visual acuity (VA) (logMAR) and intraocular straylight (C-Quant straylight parameter log[s]) under photopic conditions before and 2 weeks after YAG capsulotomy in 41 patients (53 eyes) from the Centro de Oftalmología Barraquer in Barcelona and the University Eye Clinic, Paracelsus Medical University in Salzburg. Photopic pupil diameter was also measured. To document the level of opacification, pupils were dilated, and photographs were taken with a slit lamp, using retroillumination and the reflected light of a wide slit beam at an angle of 45º. PCO was subjectively graded on a scale of 0 to 10 and using the POCOman system.

A multiple regression analysis was performed to evaluate factors that influence straylight after capsulotomy.

Results: Straylight correlated well with retroillumination and reflected-light PCO scores, whereas VA only correlated with retroillumination. Both VA and straylight improved after capsulotomy. Straylight values varied widely after capsulotomy. Multiple regression analysis showed that older age, large ocular axial length, hydrophobic acrylic intraocular lenses (IOLs), and small capsulotomies are factors that increased intraocular straylight.

Conclusion: Intraocular straylight is a useful tool in the assessment of PCO. It correlates well with PCO severity scoring methods. When performing a posterior capsulotomy, factors such as age, IOL material, axial length, and capsulotomy size must be taken into consideration, as they influence intraocular straylight.

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Càtedra de Recerca en Oftalmologia "Joaquim Barraquer" - UAB

1.3 Diagnóstico y tratamiento del queratocono 1.3.1 Resección en cuña Wedge Resection for High Astigmatism After Penetrating Keratoplasty for Keratoconus: Refractive and Histopathologic Changes Maria Fideliz de la Paz, MD, Gimena Rojas Sibila, MD, Gustavo Montenegro, MD, Juan Alvarez de Toledo, MD, Ralph Michael, PhD, Rafael Barraquer, MD, PhD, and Joaquin Barraquer, MD, PhD, FACS, FRCSOphth Purpose: To analyze the refractive, topographic, keratometric changes and the histopathologic findings after wedge resection to correct high astigmatism after penetrating keratoplasty for keratoconus.

Materials and Methods: A retrospective study was done analyzing the following parameters preoperatively and at 1, 3, and 5 years postoperatively: uncorrected visual acuity, best-corrected visual acuity, and spherical equivalent and refractive, topographic, and keratometric cylinder measures. We also studied the efficacy and safety indices, as well as the histopathologic findings of tissues submitted for pathology.

Results: A total of 22 eyes of 21 patients who underwent wedge resection in the host corneal tissue for correcting high irregular astigmatism after penetrating keratoplasty for keratoconus were included in the study. Mean follow-up time from penetrating keratoplasty to wedge resection was 18 years, whereas the mean follow-up time afterwedge resectionwas 39.04 months (range, 12-280 months). The mean preoperative refractive, topographic, and keratometric cylinders were 11.58 ± 3.52 diopters (D) (range, 4.5–20 D), 10.88 ± 5.03D(range, 2.58-21.3D), and 11.29 ± 4.33D (range, 4.50-18D), respectively. The mean postoperative refractive, topographic, and keratometric cylinders at3yearswere 4.91 ± 2.48D (range, 0.50-10D), 3.38 ± 2.10D (range, 2.057.1D), and 5.31 ± 2.90D (range, 0.50-9D), respectively. The percentage of correction at 3 years of follow up was 57.5% for refractive cylinder, 69% for topographic cylinder, and 53% for keratometric cylinder. All refractive, topographic, and keratometric data showed the lowest degree of astigmatism at 3 years postoperatively, with a tendency toward regression at 5 years postoperatively. Safety index was 1.0, whereas efficacy index was 0.49. All histopathologic sections of resected tissuewere consistent with keratoconus progression in the host peripheral cornea.

Conclusion: Wedge resection is a safe and moderately effective procedure in the correction of high astigmatism after penetrating keratoplasty for keratoconus. Histopathologic changes confirm a true late progression of the disease in the host cornea. Keratoconus may be a disease that affects the entire cornea, and surgical resection does not cure the disease.

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Càtedra de Recerca en Oftalmologia "Joaquim Barraquer" - UAB

1.3.2 Anillos intraestromales Modification and refinement of astigmatism in keratoconic eyes with intrastromal corneal ring segments David P. Piñero1, MSc, Jorge L. Alió 1, MD, PhD, Miguel A. Teus, MD, PhD, Rafael I. Barraquer2, MD, PhD, Ralph Michael2, PhD, Ramón Jiménez1, OD 1 Vissum Corporation, Alicante, Spain 2 Institut Universitari Barraquer, Universitat Autònoma de Barcelona, Barcelona, Spain PURPOSE: To analyze corneal astigmatic changes after implantation of intrastromal corneal ring segments (ICRS) in keratoconic eyes using the Alpins vectorial method.

METHODS: Keraring ICRS were implanted in eyes with a diagnosis of keratoconus. One of 3 surgeons performed the ICRS implantations using femtosecond technology and following the same protocol. Visual, refractive, keratometric, and corneal aberrometric changes were evaluated during a 12-month follow-up. Corneal astigmatic changes were also analyzed using the following Alpins vectorial components: targeted induced astigmatism (TIA), surgically induced astigmatism (SIA), difference vector, magnitude of error, flattening effect, and torque.

RESULTS: Postoperatively, there was significant visual improvement, significant central flattening, and a significant reduction in manifest astigmatism. The magnitude of SIA vector was significantly lower than the TIA postoperatively. The mean magnitude of the difference vector 3 months postoperatively was + 2.96 diopters (D) ± 1.68 (SD). The mean magnitude of error remained negative and unchanged. The mean magnitude of the flattening effect was significantly lower than the TIA at all postoperative visits. The mean magnitude of torque vector was 1.21 ± 0.98 D at 3 months. Significant negative correlations were found between preoperative corneal astigmatism and the magnitude of error and difference vector at all postoperative visits.

CONCLUSION: Although ICRS implantation significantly reduced the magnitude of corneal astigmatism, there was a trend toward undercorrection and the meridian of correction was not appropriate in all cases, showing the need for nomogram adjustments.

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Càtedra de Recerca en Oftalmologia "Joaquim Barraquer" - UAB

1.3.3 Biomecánica de la córnea The new waveform parameters from the Ocular Response Analyzer Ralph Michael1, Marek Mikielewicz1, Konstantin Kotliar2, Rafael I. Barraquer1 1 Institut Universitari Barraquer, Barcelona, Spain 2 Department of Ophthalmology, Munich University of Technology Purpose: To test the usability of 39 new waveform parameters from ORA to distinguish between normal and keratoconus (KC) eyes, to determine the severity of keratoconus and to evaluate changes after treatment with crosslinking and intrastromal ring segment implantation.

Methods: Forty waveform parameters were derived from ORA's aplanation signal curve. Data of 119 subjects were included in the study. We examined the power of discrimination between control subjects (n=48) and KC patients (stages I & II, n=54) using ROC curves. Subsequently the correlation between KC stages and the waveform parameters was tested. Finally, the changes at 4 months after the treatment with crosslinking (n=22) and intrastromal rings (n=39) were evaluated.

Results: The ROC curves of 11 parameters showed excellent results, 22 moderate and 6 parameters proved to give poor results. Although 15 of the parameters demonstrated statistically significant results (p<0.05) the correlations between KC stages and parameters were only moderate (r<0.5).

After crosslinking one parameters and after intrastromal ring implantation three parameters showed significant difference between pre and postoperative values (p<0.05).

Conclusion: Most of the new waveform parameters demonstrated good ability to discriminate between keratoconus and normal eyes. The ability to detect the severity of keratoconus was moderate.

The changes in the parameter values after treatment were smaller than expected.

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Càtedra de Recerca en Oftalmologia "Joaquim Barraquer" - UAB

1.4 Queratoprótesis y cultivo de células limbales 1.4.1 Estudio con electrofisología The role of visual evoked potential and electroretinography in the preoperative assessment of osteo-keratoprosthesis or osteo-odonto-keratoprosthesis surgery Aline Lütz de Araujo,1, 3 Victor Charoenrook,1, Rafael I. Barraquer,1, 2 Ralph Michael1

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Maria Fideliz de la Paz,1,

2

Jose Temprano,2

1 Institut Universitari Barraquer, Universitat Autònoma de Barcelona, Barcelona, Spain 2 Centro de Oftalmología Barraquer, Barcelona, Spain 3 Instituto de Oftalmologia de Porto Alegre, Porto Alegre, Brasil Purpose: To determine the value of electroretinography (ERG) and visual evoked potential (VEP) in predicting visual outcome in patients undergoing osteo-keratoprosthesis (OKP) or osteoodonto-keratoprosthesis (OOKP) surgery.

Methods: We performed a retrospective cohort study of 143 eyes in 101 patients who underwent OKP or OOKP surgery. The subjects underwent ERG, VEP testing, or both up to six months prior to surgery. The ERG and VEP results were classified into four categories based on wave amplitude, latency, and configuration. The main outcome was the maximum best corrected visual acuity (maxBCVA) reached at any time postoperatively.

Results: One hundred thirty-four cases had undergone preoperative ERG, 82 VEP, and 73 both exams.

The sensitivities of ERG and VEP to detect maxBCVA ≥ 0.05 was 68.5% and 87%, respectively, while the specificity was 63.2% for ERG and 47.4% for VEP. The maxBCVA was significantly better in patients with normal ERG (p=0.033) and those with normal VEP (p=0.048), once having defined appropriate normal and abnormal cut-off levels. When comparing fellow eyes in patients who underwent surgery in both eyes, maxBCVA was better in the eyes that had better VEP results (p=0.013).

Conclusion: Eyes demonstrating normal ERG or VEP achieved better visual outcome than those with abnormal results. In addition, VEP proved instrumental in determining the eye with the best prognosis when comparing both eyes of a given patient.

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Càtedra de Recerca en Oftalmologia "Joaquim Barraquer" - UAB

1.4.2 Cultivo de células limbales Maria Fideliz de la Paz, Juan Álvarez 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

Comparison of the Histology, Gene Expression Profile, and Phenotype of Cultured Human Limbal Epithelial Cells from Different Limbal Regions Tor P. Utheim,1,2 Sten Raeder,1,2 Ole K. Olstad,3 Øygunn A. Utheim,2 Maria de La Paz,4 Robert Cheng,5 Trang T. Huynh,1 Edward Messelt,6 Borghild Roald,7 and Torstein Lyberg1 1 Center for Clinical Research and the Departments of 2 Ophthalmology, 3 Clinical Chemistry, and 7 Pathology, Oslo University Hospital, Ulleval, University of Oslo, Oslo, Norway; 4 Institut Universitari Barraquer/Universitat Autonoma de Barcelona, Barcelona, Spain; 5 Laboratory of Metabolism, National Cancer Institute, National Institutes of Health, Frederick, Maryland; and the 6 Department of Oral Biology, Faculty of Dentistry, University of Oslo, Oslo, Norway PURPOSE. To investigate whether human limbal epithelial cells (HLECs) derived from various regions of the limbus exhibit differences in gene expression and epithelial characteristics.

METHODS. HLECs were derived from explants taken from the superior, nasal, inferior, and temporal limbus and cultured for 21 days. Whole genome transcript profiling was performed with a gene microarray. The microarray results were validated by using RT-PCR. Epithelial morphology was studied with light microscopy and transmission electron microscopy, and phenotype was evaluated by immunohistochemistry.

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Càtedra de Recerca en Oftalmologia "Joaquim Barraquer" - UAB

Experimental design of the study.

Corneoscleral explants of approximately 8 x 5 x 0.5 mm were excised from the superior, nasal, inferior, and temporal limbal regions (1). HLECs were cultured for 3 weeks on intact amniotic membranes in supplemented hormonal epithelial medium (2). Disks of cultured epithelium were trephined with a 5-mm biopsy punch and stored in cryotubes at -80°C (3a). RNA was extracted (3b). One hundred nanograms of total RNA was subjected to cDNA synthesis and labeling. Labeled and fragmented single stranded DNAs were hybridized to the gene microarray (3c) before washing and staining. The remaining HLEC cultures were fixed in neutral buffered 4% formaldehyde. A rectangular specimen including the cultured epithelium and the explant was processed and embedded in paraffin for histology and immunohistochemistry (4), whereas the remaining tissue from three cultures from each experimental group was prepared for transmission electron microscopy.

RESULTS. Epithelial outgrowth was present in most cultures of superior origin (88%) in contrast to cultures of temporal origin (38%). The epithelial thickness and number of cell layers were significantly greater in cultures of superior origin than in cultures from inferior and temporal areas. TRIM36, OSR2, and RHOU, which are involved in morphogenesis, were significantly differentially expressed in the superior region, compared with the other regions. Proposed limbal stem cell, progenitor, and differentiation markers were not differentially expressed. The uniform gene expression of ocular surface markers correlated with homogeneous immunostaining of corresponding protein markers in HLEC cultures from all regions, demonstrating an undifferentiated phenotype (p63+, ΔNp63, ABCG2+, K19+, vimentin+, integrin β1+, nestin-, K3-, K5+, and E-cadherin+).

CONCLUSIONS. No major transcriptional or phenotypic differences were observed in cultured HLECs derived from different regions of the limbus. However, explants of superior origin demonstrated the highest outgrowth success rate and generated epithelia with greater epithelial thickness and number of cell layers, which may prove useful for transplantation purposes.

(Invest Ophthalmol Vis Sci. 2009;50:5165–5172) DOI:10.1167/iovs.08-2884

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Càtedra de Recerca en Oftalmologia "Joaquim Barraquer" - UAB

2. Actividades docentes 2.1 Tesis de doctorado en desarrollo I.

Evolución del astigmatismo a largo plazo tras queratoplastia penetrante en queratocono.

Juan P. Álvarez de Toledo Elizalde. (Tesis en desarrollo).

II.

Resultados funcionales de la fotocoagulación láser mediante rejilla del edema macular diabético difuso.

Jerónimo Nadal Reus. (Tesis en desarrollo).

III.

Lentes precristalianas para la corrección de alta miopía.

Tahsin Martini.

Tutor: Prof. Joaquín Barraquer. (Tesis en desarrollo).

IV.

Endoftalmitis de etiología exógena. Revisión de datos clínicos.

Simona Nossa, Bergamo, Italia.

Tutor: Santos Muiños. (Tesis en desarrollo).

V.

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.

Fabiano Brandao M. Araujo, Brasil.

Tutor: Rafael I. Barraquer. (Tesis en desarrollo).

VI.

Capsulorhexis posterior: estudio del segmento posterior mediante OCT. Marcia Toledo.

Tutor: Rafael I. Barraquer. (Tesis en desarrollo).

VII.

Tratamiento de la hipermetropía con Fotoqueratomileusis según el frente de ondas.

Ana María Pascual Agúndez.

Tutor: Rafael I. Barraquer. (Tesis en desarrollo).

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Càtedra de Recerca en Oftalmologia "Joaquim Barraquer" - UAB

Tesis de doctorado en desarrollo VIII. Predictibilidad en el cálculo de la lente BIG-BAG en pacientes miopes altos.

Julia Sempere Matarredona.

Tutor: Rafael. I. Barraquer. (Tesis en desarrollo).

IX.

Estudio comparativo entre la cirugía de pequeña y micro-incisión: repercusiones en la barrera hematoacuosa, endotelio corneal, anatomía macular y calidad visual.

Rodrigo Abreu González.

Tutor: Rafael I. Barraquer y José Augusto Abreu. (Tesis en desarrollo).

X.

Intralase versus Microqueratomo: Estudio de la morfología y variabilidad del colgajo corneal mediante Visante. Estudio retrospectivo.

Elisa Carreras Bertran.

Tutor. Rafael I. Barraquer. (Tesis en desarrollo).

XI.

Cambios en el tejido corneal tras crosslinking.

Patricia Pujol Gomis.

Tutor: Rafael I. Barraquer. (Tesis en desarrollo).

XII.

Corrección del Astigmatismo con Láser Excimer.

Marta López Fortuny.

Tutor: Prof. Joaquín Barraquer y Andrés Picó. (Tesis en desarrollo)

XIII. Medición de la luz dispersa intraocular como nuevo parámetro para valorar la calidad visual.

Gustavo Montenegro.

Tutor: Prof. Joaquín Barraquer y Ralph Michael. (Tesis en desarrollo)

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Càtedra de Recerca en Oftalmologia "Joaquim Barraquer" - UAB

2.2 Tesis de doctorado presentada en 2010

UNIVERSIDAD DE VALLADOLID Instituto Universitario de Oftalmobiología Aplicada (IOBA) Grupo de Investigación en Superficie Ocular

CARACTERIZACIÓN Y CULTIVO DE CÉLULAS DE LA SUPERFICIE OCULAR HUMANA OBTENIDAS MEDIANTE TÉCNICAS NO INVASIVAS

Trabajo de investigación presentado por el Licenciado Hernán A. Martínez Osorio para optar al grado de Doctor por la Universidad de Valladolid en el área de conocimiento de Oftalmología

Valladolid, Enero de 2010

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Càtedra de Recerca en Oftalmologia "Joaquim Barraquer" - UAB

2.3 Trabajos de investigación Máster Máster de segmento anterior NOMBRE

TÍTULO

COORDINADOR

DRA. CARRERAS

Calidad de vida post intercambio de LIO opacificada

Isabel Canut

DR. ESPEJO

Valoración con ecografía del segmento anterior de 35 MHz de quistes y tumores

Santos Muiños

DR. KUDSIEH

Lente intraocular multifocal Acrilisa en miope magno: Resultados refractivos

Elena Barraquer

DRA. LÓPEZ

Corrección del astigmatismo en cirugía refractiva de LASIK

Andrés Picó

Comparación de los resultados refractivos y aberrométricos de tres láseres de la cirugía refractiva

Rafael I. Barraquer

Factores diagnósticos de ojo seco en pacientes con síndrome de Sjogren

Victor Charoenrook

Estudio de los posibles efectos negativos del benzalkonium chloride al nivel del endotelio corneal. Revisión bibliográfica y diseño de un estudio prospectivo

Mª Isabel Canut

DR. LOZANO

DRA. MACEDO DRA. MARCH

Mª José Capella

Jose Lamarca

Hernán Martínez

DRA. OANEA

Tratamiento coadyuvante con Mitomicina C en la F. Ruiz Tolosa cirugía filtrante del glaucoma

DR. PÉREZ

Lente intraocular monofocal en miope magno: Resultados refractivos

Elena Barraquer

DR. PONCE

Relación entre daño estructural del nervio óptico con HRT3 y electroretinograma a patrón PERG

Santos Muiños

DRA. PUJOL

Estudio retrospectivo sobre cambios en la morfología corneal tras crosslinking

Rafael I. Barraquer

19

Jose Lamarca

Càtedra de Recerca en Oftalmologia "Joaquim Barraquer" - UAB

Máster de segmento anterior NOMBRE DRA. RAFAT DR. RIBAS DRA. RIBAS GONZÁLEZ DRA. ROSANDIC

TÍTULO Cirugía de pterigión: resultados y complicaciones

COORDINADOR Victor Charoenrook

Tratamiento coadyuvante con Mitomicina C de la F. Ruiz Tolosa neoplasia conjuntival intraepitelial Uso de prp en la reconstrucción del epitelio de la superficie ocular

Rafael I. Barraquer,

Cataratas corticales en pacientes con Alzheimer

Rafael I. Barraquer,

Ralph Michael Ralph Michael

Indicaciones de la queratoplastia penetrante

R.I. Barraquer

Cambios aberrométricos inducidos en ojos sometidos a cirugía lasik mediante algoritmo esférico y asférico

Andrés Picó

DRA. SANTACRUZ

Cálculo del lente intraocular en pacientes con cirugía refractiva previa

Andres Picó

DR. SOTOMAYOR

Incisiones relajantes en pacientes con queratoconus versus non-queratoconus

Maria de la Paz

DR. WAFAIE

La deterioración del endotelio corneal por la facoemulsificación

Muhsen Samaan

DR. WERTHEIMER

Comparación de la tonometría Goldman, ORA y Pascal en diferentes grupos de pacientes

Isabel Canut

DRA. SÁNCHEZ FERREIRO DR. SÁNCHEZ-GIJÓN

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Ralph Michael

Càtedra de Recerca en Oftalmologia "Joaquim Barraquer" - UAB

Máster de segmento posterior NOMBRE DR. ADAMS DR. BONINI

DRA. CAPOTE

TÍTULO

COORDINADOR

Cirugía de vítreo-retina con queratoprótesis temporal Javier Elizalde Reintervención en agujeros maculares: uso de concentrado de plaquetas y posibles factores de riesgo para fallo quirúrgico

Jeroni Nadal

Estdio retrospectivo comparativo entre las diferentes Javier Elizalde terapias utilizadas para el tratamiento del edema macular secundario a uveitis intermedias y posteriores.

DRA. CARRERAS

Estudio macroscópico de los estafilomas de polo posterior

Jeroni Nadal

DR. EL SHARIF

Estudio del edema macular diabético tratado con triamcinolona

Javier Elizalde

DR. KUDSIEH

Terapia fotodinámica de la chorioretinopathia centralis serosa

Sonia Viver

DRA. LÓPEZ

Valor pronóstico de la autofluorescencia del EPR en Jeroni Nadal resultados postquirúrgicos en el agujero macular

DR. LOZANO

DRA. MACEDO DRA. MANTOVANI

DRA. MARCH

Desarrollar un algoritmo para evaluar cuantitativamente imágenes de autofluorescencia normales y patológicas

Ralph Michael

Comparación de la tonometría Goldman, ORA y Pascal en pacientes con vitrectomía posterior y gas

Isabel Canut

Síndrome de la tracción vítreo macular: configuración anatómica y resultados visuales postoperatorios

Javier Elizalde

Membrana neovascular en miopatía mitocondrial

Santos Muiños

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Javier Elizalde

Càtedra de Recerca en Oftalmologia "Joaquim Barraquer" - UAB

Máster de segmento posterior NOMBRE

TÍTULO

COORDINADOR

DR. MARCH

Vitreorretinopatías hereditarias infrecuentes: síndrome de Wagner

Santos Muiños

DR. PÉREZ

Estudio macular mediante OCT en pacientes con aniridia

Santiago Abengoechea

DRA. PUJOL

Estudio retrospectivo sobre la distrofia foveomacular Santiago Abengoechea viteliforme del adulto

Maria de la Paz

Tratamiento de obstrucciones de rama con triamcinolona intravítrea: Resultados y complicaciones

Sonia Viver

DRA. RIBAS GONZÁLEZ

Tratamiento de membranas neovasculares secundarias a miopía patológica con Bevacizumab

Santiago Abengoechea

DRA. SANTACRUZ

Indicaciones de la terapia fotodinámica en la era antiangiogénica

Sonia Viver

Revisión endoftalmitis

Sonia Viver

Valoración de la descompensación macular tras la extracción de catarata en pacientes con DMAE

Jeroni Nadal

DRA. RAFAT

DR. SOTOMAYOR DR. TESTI DRA. TORRES

DR. WERTHEIMER

Comparación de la eficacia y seguridad de la terapia Santiago Abengoechea fotodinámica con y sin anti-VGFT en la vasculopatía Sonia Viver polipoidea coroidea ideopática Tratamiento de la oclusión de la vena central de la retina con Triamcinolona intravítrea: resultados y complicaciones

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Sonia Viver

Càtedra de Recerca en Oftalmologia "Joaquim Barraquer" - UAB

2.4 Formación y cursos 2.4.1 Curso de Estadística Dos sábados: 6 y 20 de noviembre 2010 de 6 horas (9-15h) Docent: Lluís Costa Tutusaus Programa:    

Estructura de bases de datos en SPSS Análisis exploratorio de los datos Cálculo de tamaño de la muestra Elección de la prueba estadística

 Comparación de medias  Análisis de la variancia  Correlación y regresión lineal simple

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Càtedra de Recerca en Oftalmologia "Joaquim Barraquer" - UAB

2.4.2 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 2010:

Miércoles, 15 de diciembre 2010, 14:00 - Influence of different injectors on the endothelial cell density after DSAEK - IOP after DSAEK - Comparison of IOP measurements with ORA and Goldmann after different types of vitrectomies Martes, 23 de noviembre: 2010, 14:00 - Phaco Ersatz y cortes en el cristalino con láser de femtosegundos - Estudio Alzheimer y catarata Miércoles, 27 de octubre 2010, 14:00 Estado actual de PhacoErsatz - Calibración para medición de fuerza absoluta - Uso de un espejo para medir el grosor del cristalino - Imágenes microscópicas del cristalino Miércoles, 29 de septiembre 2010, 14:00 - Evolución del endotelio en DSAEK - Calidad visual después de DSAEK - Luz dispersa y lentes de contacto

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Càtedra de Recerca en Oftalmologia "Joaquim Barraquer" - UAB

Miércoles, 14 de julio 2010, 14:00 - Discusión de borradores de nuevos proyectos: - Calidad óptica y superficie ocular con lentes de contacto - Calidad óptica en queratoplastias penetrantes y lamelares - Evaluación de queratoplastias tras 20 años de realización - Keraflex (Corrección refractiva de la córnea mediante microondas) Miércoles, 16 de junio 2010, 14:00 - Colaboración con el Vissum en Alicante (queratocono, biobancos y nuevos proyectos) - Colaboración con el Centre Universitari de la Visió, Escola d'Òptica, UPC, Terrassa - Novedades del WOC en Berlin (evidence based studies & limbal steam cells) Miércoles, 19 de mayo 2010 14:00 - Cuantificación de las opacidades de la córnea - Novedades del ARVO 2010 y Accommodation Club 2010 Miércoles, 21 de abril 2010, 14:00 - Sistema de control de calidad para la cirugía refractiva y catarata - Evaluación de la calidad visual tras queratoplastia penetrante y lamelar - Selección de revistas para publicaciones y "Impact factor" Miércoles, 3 de marzo 2010, 14:00 - Crosslinking Miércoles, 2 de febrero 2010, 14:00 - Diagnóstico ojo seco Miércoles, 13 de enero 2010, 14:00 - Resumen y novedades de dos congresos: - Presbyopia-International, Barcelona, 11 de septiembre 2009 - International Congress of Corneal Cross Linking, 4/5 de diciembre 2009

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Càtedra de Recerca en Oftalmologia "Joaquim Barraquer" - UAB

3. Actividades en organizaciones científicas 3.1 European Association for Vision and Eye Research

Organización de dos Special Interest Symposium durante el congreso de EVER 2010: Developments in clinical and experimental aspects of posterior capsular opacification Moderators: Rafael I. BARRAQUER, Marie - José TASSIGNON Saturday 9 October 2010 from 11:00 till 12:30 in room Artemis

Functional and optical aspects of straylight in the human eye Moderators: Harilaos GINIS, Ralph MICHAEL Friday 8 October 2010 from 17:30 till 19:00 in room Zeus

3.2 Acta Ophthalmologica

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

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Càtedra de Recerca en Oftalmologia "Joaquim Barraquer" - UAB

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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Càtedra de Recerca en Oftalmologia "Joaquim Barraquer" - UAB

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

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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

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: 2010/MAY - 2012/APRIL

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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Càtedra de Recerca en Oftalmologia "Joaquim Barraquer" - UAB

5th EVI.CT.SE Members Meeting 15/16 November 2010 London, UK The meeting was attended by 133 participants.

In the Scientific Sections meetings that took place in London the Expert Committee Members were elected. At the Expert Committee meetings the following Expert Committee Coordinators were elected for the period of November 2010-2013: - AMD and Retinal Dystrophies – Prof. J. Sahel (CS nº 6) - Diabetic Retinopathy – Prof. J. Cunha-Vaz (CS nº 1) - Glaucoma – Dr. E. Hoffmann (CS nº 2) - Cornea, Cataract and Refractive Surgery – Prof. J. Alió (CS nº 7) - Ocular Surface and Inflammation – Prof. J. Murta (CS nº 70) - Reading Centers – Dr. T. Peto (CS nº 10)

El oftalmólogo y cirujano de Segmento Anterior del Centro de Oftalmología Barraquer Dr. Juan P. Alvarez de Toledo, fue elegido el pasado mes de diciembre como nuevo miembro del comité de Superficie Ocular e Inflamaciones de la sociedad "European Vision Institute”. El Comité esta constituido por otros cuatro miembros y por el Presidente.

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Càtedra de Recerca en Oftalmologia "Joaquim Barraquer" - UAB

3.4 Redes Temáticas de Investigación Cooperativa

El Instituto Universitario Barraquer es miembro de la red temática Patología Ocular del Envejecimiento, Calidad Visual y Calidad de Vida, subproyecto Calidad de Vida y Cirugía del Dioptrio Ocular desde 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.

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Càtedra de Recerca en Oftalmologia "Joaquim Barraquer" - UAB

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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Càtedra de Recerca en Oftalmologia "Joaquim Barraquer" - UAB

4. Publicaciones 4.1 Publicaciones en revistas Montenegro GA, Marvan P, Dexl A, Picó A, Canut MI, Grabner G, Barraquer RI, Michael R. Posterior capsule opacification assessment and factors that influence visual quality after posterior capsulotomy.

Am J Ophthalmol. 2010 Aug;150(2):248-53. de la Paz MF, Sibila GR, Montenegro G, de Toledo JA, Michael R, Barraquer R, Barraquer J. Wedge resection for high astigmatism after penetrating keratoplasty for keratoconus: refractive and histopathologic changes.

Cornea. 2010 Jun;29(6):595-600.

Michael R, Barraquer RI, Rodríguez J, Tuñi i Picado J, Serra Jubal J, González Luque JG, van den Berg T. Intraocular straylight screening in medical testing centres for driver licence holders in Spain.

J Optom. 2010;3(2):107-114.

Michael R, Montenegro GA, Barraquer RI. Intraocular straylight and contrast sensitivity two months after LASIK. J Emmetropia 2010; 1: 59-63.

Capella MJ, Barraquer E. Estudio comparativo entre cirugía de catarata por microincisión coaxial y facoemulsificación estándar.

Arch Soc Esp Oftalmol. 2010;85(8):268–273 Nischler C, Michael R, Wintersteller C, Marvan P, Emesz M, Van Rijn LJ, van den Berg TJ, Wilhelm H, Coeckelbergh T, Barraquer RI, Grabner G, Hitzl W. Cataract and pseudophakia in elderly European drivers.

Eur J Ophthalmol. 2010 Sep-Oct;20(5):892-901.

Piñero DP, Alio JL, Barraquer RI, Michael R, Jiménez R. Corneal biomechanics, refraction, and corneal aberrometry in keratoconus: an integrated study.

Invest Ophthalmol Vis Sci. 2010 Apr;51(4):1948-55.

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Càtedra de Recerca en Oftalmologia "Joaquim Barraquer" - UAB

Publicaciones en revistas Piñero DP, Alió JL, Teus MA, Barraquer RI, Michael R, Jiménez R. Modification and refinement of astigmatism in keratoconic eyes with intrastromal corneal ring segments.

J Cataract Refract Surg. 2010 Sep;36(9):1562-72.

Piñero DP, Alio JL, Teus MA, Barraquer RI, Uceda-Montañés A. Modeling the intracorneal ring segment effect in keratoconus using refractive, keratometric, and corneal aberrometric data.

Invest Ophthalmol Vis Sci. 2010 Nov;51(11):5583-91.

Ferrer C, Alió JL, Montañés AU, Pérez-Santonja JJ, del Rio MA, de Toledo JA, Teus MA, Javaloy J. Causes of intrastromal corneal ring segment explantation: clinicopathologic correlation analysis.

J Cataract Refract Surg. 2010 Jun;36(6):970-7.

Publicaciones en libros Michael R. Cortical Cataract.

In: Encyclopedia of the Eye. Editor: Darlene A. Dartt. Vol 1.

Oxford: Academic Press; 2010. pp. 532-536.

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

4.2 Presentaciones en congresos internacionales

The Association for Research in Vision and Ophthalmology

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Presentation Abstract Program#/Poster#:

4984/D780

Abstract Title:

The Usability of the New Waveform Parameters From the Ocular Response Analyzer in the Characterization of Keratoconus

Presentation Start/End Time:

Wednesday, May 05, 2010, 3:45 PM - 5:30 PM

Session Number:

478

Session Title:

Keratoconus and Collagen Crosslinking

Location:

Hall B/C

Reviewing Code:

162 corneal biomechanics - CO

Author Block:

R. Michael1, M. Mikielewicz1, K. Kotliar2, R.I. Barraquer1. 1Institut Universitari Barraquer, Barcelona, Spain; 2Department of Ophthalmology, Munich University of Technology, Munich, Germany.

Keywords:

573 keratoconus

Abstract Body:

Purpose: To test the usability of 39 new waveform parameters from ORA to distinguish between normal and keratoconus (KC) eyes, to determine the severity of keratoconus and to evaluate changes after treatment with crosslinking and intrastromal ring segment implantation.

Methods: Forty waveform parameters were derived from ORA's aplanation signal curve. Data of 119 subjects were included in the study. We examined the power of discrimination between control subjects (n=48) and KC patients (stages I & II, n=54) using ROC curves. Subsequently the correlation between KC stages and the waveform parameters was tested. Finally, the changes at 4 months after the treatment with crosslinking (n=22) and intrastromal rings (n=39) were evaluated.

Results: The ROC curves of 11 parameters showed excellent results, 22 moderate and 6 parameters proved to give poor results. Although 15 of the parameters demonstrated statistically significant results (p<0.05) the correlations between KC stages and parameters were only moderate (r<0.5). After crosslinking one parameter and after intrastromal ring implantation two parameters showed significant difference between pre and postoperative values (p<0.05).

Conclusions: Most of the new waveform parameters demonstrated good ability to discriminate between keratoconus and normal eyes. The ability to detect the severity of keratoconus was moderate. The changes in the parameter values after treatment were smaller than expected.

CommercialRelationships: R. Michael, None; M. Mikielewicz, None; K. Kotliar, None; R.I. Barraquer, None.

Support:

FIS PI08/90726

Š2010, 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.

Presentation Abstract Program#/Poster#:

5425/A441

Abstract Title:

Posterior Capsule Opacification Assessment and Factors That Influence Visual Quality After Posterior Capsulotomy

Presentation Start/End Time:

Thursday, May 06, 2010, 8:30 AM -10:15 AM

Session Number:

518

Session Title:

Cataract Surgery

Location:

Hall B/C

Reviewing Code:

426 No Reviewing Code applies â&#x20AC;&#x201C; LE

Author Block:

G.A. Montenegro1, P. Marvan2, A. Dexl2, G. Grabner2, R. Barraquer1, R. Michael1.

1Research, Institut Universitari Barraquer, Barcelona, Spain; 2Research, Paracelsus Medical University, Salzburg, Austria.

Keywords:

649 posterior capsular opacification (PCO), 566 intraocular lens, 627 optical properties

Abstract Body:

Purpose: To study the correlation of posterior capsule opacification (PCO) with measured intraocular straylight and visual acuity.

Methods: Visual acuity (VA) (logMAR) and intraocular straylight (C-Quant straylight parameter log[s]) were measured under photopic conditions before and 2 weeks after YAG capsulotomy in 53 eyes (41 patients). Photopic pupil diameter was measured. To document the amount of opacification, pupils were dilated and photographs were taken at a slit lamp, using retroillumination and the reflected-light of a wide slit beam at an angle of 45 degrees focused on the posterior capsule. PCO was subjectively graded on a scale from 1 to 10 and using POCOman. A multiple regression analysis was performed to evaluate factors that influence straylight after capsulotomy.

Results: Straylight showed a good correlation with retroillumination and reflected-light PCO grading whereas VA only correlated with retroillumination. Both VA and straylight improved after capsulotomy. Straylight values presented a large variation after capsulotomy. Multiple regression analysis showed that increasing age and ocular axial length, hydrophobic acrylic IOLs, and small capsulotomies are factors that increased intraocular straylight.

Conclusions: Intraocular straylight is a useful tool in the assessment of PCO. It correlates well with PCO severity grading methods. When performing a posterior capsulotomy, factors such as age, IOL material, axial length, and capsulotomy size must be taken into consideration as they have an influence on intraocular straylight.

CommercialRelationships: G.A. Montenegro, None; P. Marvan, None; A. Dexl, None; G. Grabner, None; R. Barraquer, None; R. Michael, None.

Support:

None

Š2010, 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.

Presentation Abstract Program#/Poster#:

5419/A435

Abstract Title:

Korrelation of Intraocular Staylight and Visual Acutity Before and After Yag Capsulotomy

Presentation Start/End Time:

Thursday, May 06, 2010, 8:30 AM -10:15 AM

Session Number:

518

Session Title:

Cataract Surgery

Location:

Hall B/C

Reviewing Code:

144 cataract surgery – LE

Author Block:

P.P. Marvan1,2, M. Rasp1, T. Rückl1, R. Michael2, A. Dexl1. 1Ophthalmologie, Paracelsus Medical University, Salzburg, Austria; 2Ophthalmologie, Institut Universitari Barraquer, Barcelona, Spain.

Keywords:

750 visual acuity, 421 anterior segment, 437 brightness and lightness

Abstract Body:

Purpose: Examination of visual impaiment due to posterior capsular opacification, especially the correlation of intraocular straylight and vision, before and after YAG-Capsulotomy.

Methods: In a prospektive bicentrical study (Barcelona/Spain, Salzburg/Austria), 45 eyes were examined. We tested visual acuity (Snellen) and intraocular straylight (C-Quant, straylightparameter (log[s])) before and two weeks after YAG-Capsulotomy under photopical conditions. In each case the straylight testing was performed in myosis and with dilated pupills.

Results: Patients with posterior capsular opacification had a lower vision (0,52sn + 0,2) and higher straylight values (1,52 log(s) + 0,49). Comparing the staylight values with dilated pupills (1,69 log(s) + 0,53) to the values in myosis, there was an even higher significant increase of straylight. After performing a YAG-Capsulotomy there was a significant increase of visual acuity (0,86sn + 0,17), aswell as a significant advancement of the straylight values in myosis (1,31 log(s) + 0,21). Unexpectedly there was no post OP significant advancement of the straylight value in dilated pupills (1,56 log (s) + 0,22) Conclusions: Performing a YAG-Capsulotomy leads to a significant advancement of visual acuity and therefore to more patient satisfaction. It leads aswell to a significant decrease of intraocular straylight and so to less glare. Both, pre- and postoperativly, the straylight values show a significant increase, when the pupill is dilated. This may happen due to occurrence of spherical and chromatical aberations.

CommercialRelationships: P.P. Marvan, None; M. Rasp, None; T. Rückl, None; R. Michael, None; A. Dexl, None.

Support:

None

©2010, 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.

Presentation Abstract Program#/Poster#:

4633/D755

Abstract Title:

Predictive Model for the Visual Outcome After Keraring Implantation in Keratoconus Considering Corneal Biomechanics

Presentation Start/End Time:

Wednesday, May 05, 2010, 1:45 PM - 3:30 PM

Session Number:

458

Session Title:

Corneal Biomechanics

Location:

Hall B/C

Reviewing Code:

162 corneal biomechanics - CO

Author Block:

D.P. Pinero1, J. Alio1, R. Barraquer2, R. Michael2A. 1R & D, Vissum Corporation Alicante, Alicante, Spain; AR & D, 2Centro de Oftalmología Barraquer, Barcelona, Spain.

Keywords:

573 keratoconus, 479 cornea: clinical science,

Abstract Body:

Purpose: To evaluate by means of the Ocular Response Analyzer (ORA) the biomechanical changes after intracorneal ring segment (ICRS) implantation and to develop a predicting model for the postoperative visual outcome considering these biomechanical changes.

Methods: A total of 45 consecutive keratoconic eyes of 35 patients ranging in age from 18 to 55 years and implanted with ICRS were included. All cases were implanted with KeraRing using the femtosecond laser technology. Visual acuity, refraction, corneal topography and aberrations were evaluated during a 6-month follow-up. Additionally, corneal biomechanical changes were also evaluated with the ORA system.

Results: No significant changes in corneal hysteresis (CH) and corneal resistance factor (CRF) were observed at 1 month postoperatively (p≥0.34). However, posterior changes in these parameters were detected (CH, 3 months, p=0.01). Significant correlations of the 1-month postoperative corrected distance visual acuity (CDVA) with keratometry (r=0.71, p<0.01) and also with corneal higher order aberrations (r=0.61, p=0.01) were found, but these correlations were lost during the follow-up. Multiple regression analysis revealed that CDVA at 1 month after surgery was significantly correlated with the preoperative mean keratometry and the preoperative difference between CH and CRF (p<0.01, adjusted R2 of 0.68). A less predictable model was found for the 6-month CDVA. Conclusions: Biomechanical parameters measured with the ORA and mean keratometry are factors allowing a prediction of the postoperative visual outcome in a short term after ICRS implantation in keratoconic eyes. In the long term, corneal biomechanical changes limit the ring segment effect.

CommercialRelationships: D.P. Pinero, None; J. Alio, None; R. Barraquer, None; R. Michael, None.

Support:

None

©2010, 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.

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

World Ophthalmology Congress Berlin 5 - 9 June 2010

40

WOC® 2010

Roof Garden 10:30 - 12:30

SU-70

Highlights of Anterior Segment Surgery & Refractive Surgery Symposium Cataract, Refractive Surgery

10:38 IL Sonophaco & injectable lenses Maria-Elena Barraquer (Barcelona/E)

SU-70-05

10:43 IL SU-70-07 Management of intraoperative small pupil Rafael Barraquer (Barcelona/E)

This 120-minutes multi-authored Symposium is divided in five different sections: 1. Cataract Surgery; 2. Corneal Surgery; 3. Refractive Surgery (Cornea and Lens); 4. Surgical Management of Glaucoma; and 5. Management of Ocular Injuries.

Each section comprises several “rapid fire contributions” of different members of the team from Barcelona, illustrated with didactic material and challenging casuistics. Cataract surgery is reviewed from the suction cup procedure for intracapsular extraction, called Phacoerysis, invented in 1917, inclusion of intraocular anterior chamber lenses to correct aphakia (1954) and enzymatic zonulolysis to overcome zonular resistence prior to the extraction (1958), to modern techniques such as sonophaco and injectable lenses with due consideration to management of certain complications, such as secondary cataract and intraoperative small pupil.

In the Section on Corneal Surgery the techniques of anterior and posterior lamellar procedures are presented. The topics discussed in the Section on Refractive surgery (Cornea and Lens) include molding of the cornea (crosslinking), photokeratomileusis for astigmatismus, tectonic and refractive large diameter penetrating keratoplasties, clear lens extraction and multifocal IOL. In Glaucoma Surgery, besides advances in goniotomy and iridotomy, the procedure of non-perforating deep sclerecotomy with intrascleral T-Flux implantation is highlighted.

The Section of Management of Ocular Injuries includes modern approach of severe physical (explosion) and chemical trauma.

Cataract Surgery SU-70-01

10:31 IL SU-70-02 Phacoeresis of Professor Ignacio Barraquer Maria-Elena Barraquer (Barcelona/E) 10:33 IL Enzymatic Zonulolysis Joaquin Barraquer (Barcelona/E)

SU-70-04

10:42 IL SU-70-06 YAG Laser capsulotomy for secondary cataract Isabel Canut (Barcelona/E)

Chairs: Joaquin Barraquer (Barcelona/E) Rafael Barraquer (Barcelona/E) Maria-Elena Barraquer (Barcelona/E)

10:30 IL Introduction Joaquin Barraquer (Barcelona/E)

10:37 IL Strampelli’s anterior chamber IOL Joaquin Barraquer (Barcelona/E)

SU-70-03

10:49 Discussion

Corneal Surgery 10:58 IL Lamellar anterior keratoplasty Rafael Barraquer (Barcelona/E)

SU-70-08

11:03 IL Lamellar posterior keratoplasty J. P. Alvarez de Toledo (Barcelona/E)

SU-70-09

11:08 Discussion

Refractive Surgery 11:13 IL SU-70-10 Molding of the cornea from intracorneal segments to collagen crosslinking Rafael Barraquer (Barcelona/E) 11:22 IL SU-70-11 Photokeratomileusis in astigmatismus induced by keratoplasty J. P. Alvarez de Toledo (Barcelona/E) 11:25 IL SU-70-12 Large diameter penetrating keratoplasties (Tectonic and refractive) Joaquin Barraquer, Mercé Uxó (Barcelona/E) 11:37 IL Clear lens extraction and multifocal IOL Maria-Elena Barraquer (Barcelona/E) 11:42 Discussion

SU-70-13

Sunday, 6 June

Sunday, 6 June 2010

Scientific Program Schedule

123

WOC® 2010

Scientific Program Schedule

Sunday, 6 June

124

Sunday, 6 June 2010 Surgical Management of Glaucoma 11:47 IL SU-70-14 Goniotomy Ignacio García-Barberán, Joaquin Barraquer (Barcelona/E) 11:49 IL Peripheral Iridotomy Muhsen Samaan (Barcelona/E)

14:20 IL Management of Lacrimal Trauma Hunter K. L. Yuen (Kowloon/HK)

SU-71-03

14:30 IL Current Techniques in DCR Yannis Ntountas (GR)

SU-71-04

SU-70-15

11:50 IL SU-70-16 Non-perforating deep sclerectomy with intrascleral implantation of T-Flux Isabel Canut, Joaquin Barraquer (Barcelona/E)

14:40 IL SU-71-05 Microendoscopy of the Lacrimal Outflow System – Efficacy of Endoscopic Lacrimal Duct Recanalization using Microendoscope Reynaldo M. Javate (Manila/RP)

11:55 Discussion

14:50 IL SU-71-06 Influence of Microendoscopic Techniques to Lacrimal Surgery Karl-Heinz Emmerich (Darmstadt/D)

Management of Ocular Injuries

15:00 Discussion

12:00 IL SU-70-17 Bomb explosion affecting both eyes Joaquin Barraquer, Mercé Uxó (Barcelona/E)

Roof Garden 16:00 - 17:30

12:14 IL SU-70-18 Alkali burn with extensive ocular surface alterations Juan P. Alvarez de Toledo, Mª de la Paz (Barcelona/E) 12:21 IL SU-70-19 Keratoprosthesis Joaquin Barraquer, José Temprano (Barcelona/E) 12:25 Discussion

14:00 - 15:30

Symposium Pediatric Ophthalmology Chairs: Wolf A. Lagrèze (Freiburg/D) Daniel Mojon (St. Gallen/CH) Herbert Jägle (Regensburg/D) SU-72-01

SU-71

New Diagnostic and Therapeutic Aspects of Lacrimal Diseases Symposium Oculoplasty, Lacrimal System, Orbit

16:15 IL SU-72-02 Advances in the treatment of pediatric glaucoma Peng T. Khaw (London/UK) 16:30 IL SU-72-03 Current management of pediatric cataract Wolf A. Lagrèze (Freiburg/D)

Chairs: Karl-Heinz Emmerich (Darmstadt/D) Reynaldo M. Javate (Manila/RP) James Oestreicher (Toronto/CDN)

16:45 IL SU-72-04 Current management of capillary hemangioma Herbert Jägle (Regensburg/D)

14:00 IL SU-71-01 Clinical and Imaging Evaluation of the Tearing Patient James Oestreicher (Toronto/CDN) 14:10 IL Congenital Lacrimal Disorders Franz Josef Steinkogler (Vienna/A)

Strategies in Surgical Treatment of Eye Diseases in Childhood

16:00 IL Minimally invasive strabismus surgery Daniel Mojon (St. Gallen/CH)

Roof Garden

SU-72

SU-71-02

17:00 IL Anti VEGF for ROP Michael T. Trese (Royal Oak/USA) 17:15 Discussion

SU-72-05

WOC® 2010

Monday, 7 June

Courses and Wetlabs

252

Monday, 7 June 2010

Update on Tonometry

Conclusion a. Nomograms b. Flow-chart c. Which tonometer is best. d. The future

Chair: Harry Mark (North Haven/USA)

Room 43

Room 43 08:30 - 10:00

WOC-C-38

Speakers: Harry Mark (North Haven/USA) Course fees: 50 c / 75 c

10:30 - 12:00

WOC-C-39

A Flexible Ring in a Corneal Pocket for the Treatment of Keratoconus and Myopia

Synopsis: Year after year patents are issued for new tonometers, each claiming to be more accurate and comfortable, though none measures true intra-ocular pressure. This course will present the latest tonometers and the evidence concerning the physical parameters of the eye that influence all tonometric reading. Clinical examples of their application in myopia, normal-tension glaucoma, and ocular hypertension will illustrate their utility.

Chairs: Albert Daxer (Linz/A), Haifa Mahmood (Manama/BRN)

Objective: At the end of this course attendees will be able to apply tonometric information more confidently and reliably in the diagnosis and management of glaucoma, and decide when to obtain ancillary data, such as corneal thickness. The course will also help attendees choose a tonometer.

Objectives: Attendees will understand corneal intrastromal implantations surgery (CISIS) using a flexible, continous ring implant placed within a closed corneal pocket for the btreatment of keratoconus and myopia.

Introduction a. Many U.S. patent applications for new tonometers annually. b. Brief history. Helmholtz’s first tonometer. c. Need for standard quantification Geometry and physics a. Size and shape. 1. Acrophthalmos.

2. Brachophthalmos. b. Envelope. 1. Cornea 2. Sclera. 3. Optic foramen. c. Contents. 1. Aqueous. 2. Vitreous. d. Pressure from within (IOP). e. Pressure from without – the tonometer’s f. Imbert-Fick law: the elusive mmHg Necessity of ancillary data a. Central corneal thickness b. Corneal curvature c. Ocular volume (axial length, A and B scans) d. Elasticity (scleral thickness) e. Corneal hysteresis f. Terminology and reimbursement Clinical application a. Glaucoma suspect, risk factors. b. Normal/low-tension glaucoma c. Ocular hypertension d. Gender differences e. Myopia and glaucoma

Speakers: Albert Daxer (Linz/A), Millicent Grim (Dubai/UAE), Haifa Mahmood (Manama/BRN), Ali Rahji (Riyadh/SA), Pavel Studeny (Sokolov/CZ) Course fees: 50 c / 75 c

Description: The course will review clinically important aspects of CISIS including surgical techniques, inclusion criteria, and nomograms, complications and side effects, case studies and statistical data. The surgical techniques are demonstrated via educational videos.

Room 43 14:00 - 15:30

WOC-C-40

Modern Surgery of the Posterior Segment of the Eye Chairs: Joaquin Barraquer (Barcelona/E), Rafael Barraquer (Barcelona/E), Jeroni Nadal (Barcelona/E) Speakers: Joaquin Barraquer (Barcelona/E), Rafael Barraquer (Barcelona/E), Javier Elizalde (Barcelona/E), Jeroni Nadal (Barcelona/E) Course fees: 50 c / 75 c In this 90 minutes “multi-authored” Course the following topics are discussed:

WOC® 2010

1) Surgical management of proliferating vitreoretinopathy with special emphasis on different techniques of peeling of the epiretinal and retroretinal membranes, the use of biological colorants and intraocular tamponnades.

2) Presentation of an update of modern surgical techniques in macular surgery, different options, use of biologic colorants and indications for peeling of the internal limiting membrane.

3) Biopsy techniques for cytogenic studies of uveal melanoma, especially cytogenic phenotyping, an universally accepted procedure in ocular oncology to evaluate the risk of metastatic desease in uveal melanoma. Different approaches for microsurgical procedures to achieve the obtention of adequate tumor samples are described in detail.

4) Conservative resection of uveal melanoma is reviewed on the basis of personal experience with different techniques of local conservative resection as a valid option in the management of selected cases of uveal melanoma.

5) Finally: Ligature of afferent vessel for retinal haemangioma, a new surgical technique for management of yuxtapapillar capillar haemangioma is described. Ligature of the afferent artery to the tumor has been performed and proved to be effective to reduce the volume of the haemangioma and exudative activity at the level of the posterior pole. Images from the different authors’ personal casuistics will be shown to illustrate the presentations.

Ligature of afferent vessel for retinal hemangioma Jeroni Nadal (Barcelona/E) Conservative resection of uveal melanoma Rafael Barraquer (Barcelona/E) Biopsy techniques for cytogenic study of uveal Melanoma Javier Elizalde (Barcelona/E) Macular Surgery Joaquin Barraquer, Jeroni Nadal (Barcelona/E) Surgical management of proliferating vitreoretinopathy Jeroni Nadal (Barcelona/E)

Room 43 16:00 - 17:30

WOC-C-41

Complications in Vitreoretinal Surgery Chairs: David S. H. Wong (Hong Kong/HK), Paul Sullivan (London/UK), Karl Ulrich Bartz-Schmidt (Tübingen/D) Speakers: George William Aylward (London/UK), Keith Barton (London/UK), Karl Ulrich Bartz-Schmidt (Tübingen/D), Rubens Belfort, Jr. (São Paulo/BR), Carlos Pavesio (London/UK), Paul Sullivan (London/UK), Charles P. Wilkinson (Baltimore/USA), David S. H. Wong (Hong Kong/HK) Course fees: 50 c / 75 c Per operative Complications of scleral buckling surgery Paul Sullivan (London/UK) Retinal Trauma from vitreoretinal surgery Karl Ulrich Bartz-Schmidt (Tübingen/D) Inflammation and Infection after vitreoretinal surgery Rubens Belfort, Jr. (São Paulo/BR) Glaucoma after vitreoretinal surgery Keith Barton (London/UK) Complications of tamponade agents David S. H. Wong (Hong Kong/HK) Complications of vitrectomy for diabetic retinopathy Charles P. Wilkinson (Baltimore/USA)

Courses and Wetlabs

Monday, 7 June 2010

Monday, 7 June

253

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

45

European Association for Vision and Eye Research ESCRS: Developments in clinical and experimental aspects of posterior capsular opacification (PCO)

Starting from an optical point of view of posterior capsular opacification in cell culture, we will discuss surgical and non-surgical aspects of prevention and conclude with the effects of laser capsulotomy on the visual quality of patients.

Session type Joint Meeting Moderators for this session Rafael I. BARRAQUER, Marie - José TASSIGNON Time and place of session This session will take place on Saturday 9 October 2010 from 11:00 till 12:30 in room Artemis.

Abstracts assigned to this session (5) 11:00

15'

4241

Optical characterization of PCO

VAN DEN BERG TJTP, VAN BREE MCJ

11:15

15'

4242

Elschnig pearl formation and disappearance

HIRNSCHALL N, NEUMAYER T, FINDL O

11:30

20'

4243

Capsular peeling in premium IOLs to improve visual outcome

TASSIGNON MJ, ROZEMA J

11:50

15'

4244

Posterior capsule surgery and posterior capsulorhexis

BARRAQUER RI

12:05

15'

4245

Non-surgical strategies for PCO prevention

WORMSTONE IM

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

European Association for Vision and Eye Research e4244 - Posterior capsule surgery and posterior capsulorhexis Additional information Session information This abstract has been assigned to session ESCRS: Developments in clinical and experimental aspects of posterior capsular opacification (PCO).

This session will take place on Saturday 9 October 2010 from 11:00 till 12:30 in room Artemis.

Authors Author 1

BARRAQUER RI Institut Universitari Barraquer (Barcelona)

Abstract To review the available intraoperative maneuvers to reduce the occurrence of posterior capsule opacification (PCO) after cataract surgery, including lens epithelial cell Purpose aspiration (LECA), posterior capsular membrane removal (PCMR), and posterior capsulorhexis (PCRX).

Review of the literature and of the available techniques to prevent PCO. Case-control Methods retrospective studies on the efficacy of LECA for PCO prevention and on the safety of PCRX, namely its influence on vitreoretinal complications.

To reduce PCO, a number of surgical maneuvers have been described, including LECA, PCMR and PCRX, with variable results. In a series of consecutive 1574 eyes of 1147 patients followed-up a minimum of 3 years, performing a meticulous LECA following phacoemulsification (PE) reduced PCO occurrence from 36.6% to 17.2% Results (p>0.01). In another series of consecutive 2.441 eyes operated of PE with or without PCRX, the rate of retinal detachment and cystoid macula edema was nonsignificantly higher after PCRX than cases with an intact capsule (respectively p=0.065 and p=0.32), while comparing favorably to Nd:YAG laser capsulotomy and with unplanned capsule tears.

Intraoperative capsular techniques such as LECA, PCMR and PCRX may effectively and safely reduce PCO. The variability of the results in the literature may be due to the Conclusionsmultiple nonsurgical factors involved (lens design and materials, associated conditions, etc.), as well as minor surgical details indicating that the surgeon factor should not be understated.

EVER Office - European Association for Vision and Eye Research Kapucijnenvoer 33, B-3000 Leuven, Belgium ever@ever.be â&#x20AC;˘ tel +32 16 233 849 â&#x20AC;˘ fax +32 16 234 097

European Association for Vision and Eye Research VEP: Functional and optical aspects of straylight in the human eye The point spread function (PSF) in the human eye is characterized by a central region governed by the aberrations of the optical system and a large peripheral part mostly governed by scattered light (straylight). The PSF itself carries all the information about the imaging quality of the system and the associated visual influence. Very often the impact of straylight is neglected and/or poorly understood. The symposium focuses on the techniques for the measurement of straylight in the human eye, the prevalence of straylight in the population and the role of different structures in the eye (such as cataract or corneal edema) that are associated with increased straylight.

Session type Special Interest Symposium Moderators for this session Harilaos GINIS, Ralph MICHAEL Time and place of session This session will take place on Friday 8 October 2010 from 17:30 till 19:00 in room Zeus.

Abstracts assigned to this session (6) 17:30

15'

3421

Straylight and vision

VAN DEN BERG TJTP, VAN DER MEULEN IJE

17:45

15'

3422

Sources of straylight in the human eye

DE BROUWERE D, GINIS HS

18:00

15'

3423

Measurement of straylight

GINIS HS

18:15

15'

3424

Posterior capsule opacification assessment and factors that influence visual quality after posterior capsulotomy

MICHAEL R, MONTENEGRO G, GRABNER G, BARRAQUER RI

18:30

15'

3425

Influence of cataract morphology on retinal straylight and straylight changes due to cataract surgery using the Morcher 89A Bag in the LensTM

TASSIGNON MJ

18:45

15'

3426

Straylight and corneal edema

PENTARI IG, GINIS HS, PENNOS A, PALLIKARIS IG

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

European Association for Vision and Eye Research e3424 - Posterior capsule opacification assessment and factors that influence visual quality after posterior capsulotomy Additional information Session information This abstract has been assigned to session Functional and optical aspects of straylight in the human eye .

This session will take place on Friday 8 October 2010 from 17:30 till 19:00 in room Zeus.

Authors MICHAEL R Institut Universitari Barraquer (Barcelona) MONTENEGRO G Author 2 Institut Universitari Barraquer (Barcelona) GRABNER G Author 3 University Eye Clinic, Paracelsus Medical University (Salzburg) BARRAQUER RI Author 4 Institut Universitari Barraquer (Barcelona) Abstract To study the correlation between posterior capsule opacification (PCO) and intraocular Purpose straylight and visual acuity.

We measured visual acuity (VA) (logMAR) and intraocular straylight (C-Quant straylight parameter log[s]) under photopic conditions before and 2 weeks after YAG capsulotomy in 41 patients (53 eyes) from the Centro de Oftalmología Barraquer in Barcelona and the University Eye Clinic, Paracelsus Medical University in Salzburg.

Photopic pupil diameter was also measured. To document the level of opacification, Methods pupils were dilated, and photographs were taken with a slit lamp, using retroillumination and the reflected light of a wide slit beam at an angle of 45º. PCO was subjectively graded on a scale of 0 to 10 and using the POCOman system. A multiple regression analysis was performed to evaluate factors that influence straylight after capsulotomy.

Straylight correlated well with retroillumination and reflected-light PCO scores, whereas VA only correlated with retroillumination. Both VA and straylight improved after capsulotomy. Straylight values varied widely after capsulotomy. Multiple Results regression analysis showed that older age, large ocular axial length, hydrophobic acrylic intraocular lenses (IOLs), and small capsulotomies are factors that increased intraocular straylight.

Intraocular straylight is a useful tool in the assessment of PCO. It correlates well with PCO severity scoring methods. When performing a posterior capsulotomy, factors Conclusions such as age, IOL material, axial length, and capsulotomy size must be taken into consideration, as they influence intraocular straylight.

Author 1

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

European Association for Vision and Eye Research e3323 - Neural contrast sensitivity calculated from measured total contrast sensitivity and modulation transfer function Topics Whole eye - Clinical sciences - Vision research Additional information Oral presentation Session information This abstract has been assigned to session Visual psychophysics, optics and quality of vision.

This session will take place on Friday 8 October 2010 from 13:45 till 15:15 in room Zeus.

Authors MICHAEL R Institut Universitari Barraquer (Barcelona) GUEVARA O Author 2 Institut Universitari Barraquer (Barcelona) Centro Médico Teknon (Barcelona) BARRAQUER RI Author 3 Institut Universitari Barraquer (Barcelona) Abstract To test the feasibility of calculating neural contrast sensitivity function (neural CSF) from conventionally measured total contrast sensitivity function (total CSF) and Purpose measured modulation transfer function (MTF). Neural CSF considers the retina and the brain, whereas total CSF considers the optical eye media, the retina and the brain together.

Three groups with 9 eyes each, one group with normal ocular optics but with retinal Methods alterations (mild diabetic retinopathy), another with altered ocular optics and normal retina (keratoconus) and a normal control group were studied.

Total CSF in the keratoconus and retinopathy group was significantly lower as compared with the control group. MTF for keratoconus was lower and in the retinopathy group was similar to the control group. Calculated neural CSF in the Results diabetes mellitus group was lower than in the control group whereas in the keratoconus group it was similar to the control group, with overestimations for some keratoconus cases.

It is possible to calculate a meaningful neural CSF from measured total CSF and MTF data. The neural CSF represents a CSF adjusted for optical aberrations. This would Conclusions allow comparing the neural component of visual function in eyes with different optical aberrations.

Author 1

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