After medical school and my ophthalmology residency in Brazil, I went to Paris (Hôtel-Dieu de Paris) for a retina fellowship. After two years, I was approached by one of the professors in the ophthalmology department about a PhD program that included a project on surface modification of IOLs. I thought it would be great for my CV, and (I admit, more importantly) it would mean staying in Paris for at least four more years! Through this program I really entered the IOL world, and became fascinated by these devices that can be implanted inside of the eye and remain transparent and functional throughout a lifetime. Also during that time, I realized that scientific methodology is a good match to my personality.
When finishing my PhD in Paris, my thesis director suggested I spend a year in the laboratory of David Apple, in Charleston, South Carolina. It was supposed to be only a year, after which I would go back to Paris. However, six months into the fellowship, David was diagnosed with cancer, and I was invited to stay longer, obtaining the status of Visiting Assistant Professor. David had started working on IOL research at the University of Utah with our chair, Randall Olson. So, after spending three and a half years in Charleston, we moved the laboratory back to Salt Lake City, and that is how I ended up making my career at the Moran Eye Center. It is an absolutely great center, and I cannot overemphasize how supportive our chair and the whole professional environment here is to our research!
There are three main types of work we perform in our laboratory. We perform a significant number of in vivo preclinical studies in the rabbit model, and are currently evaluating the uveal and capsular biocompatibility of new IOL materials/designs, including accommodating, modular, adjustable and drug-eluting lenses. We also perform ex vivo studies using human eyes obtained postmortem, evaluating new implantable devices, surgical techniques or surgical equipment, as well as evaluating the biocompatibility of IOLs in pseudophakic donor eyes. One of my favorite parts of our work involves analyzing IOLs and other implantable ocular devices that have been explanted from patients because of different complications. To analyze these, we have to use various techniques, such as histochemistry, surface analytical methods and histopathology.
Perhaps the body of work on IOL complications, including various causes of IOL opacification and their impact on visual function. Considering the number of new materials and designs under development – or entering the market – constant vigilance is necessary.
An IOL that, besides exhibiting excellent biocompatibility, clarity, and optical quality, would also allow for insertion through very small incisions, non-invasive multiple and reversible power adjustments, and be accommodating.
We never arrive anywhere alone, and there are so many people throughout my life to acknowledge. To name just a few, I have to first of all acknowledge my parents for their constant and unconditional support. At the professional level, Jean-Marc Legeais was my PhD thesis director, and helped me enter this interesting world of IOL research. My move to the US to work with David Apple was fundamental to my career and I am so grateful to all opportunities I had while working with him. And, since 2002, I feel very privileged to work with prominent colleagues such as Nick Mamalis and Alan Crandall under the leadership of Randall Olson at the Moran Eye Center.
I love that our research to help improve an IOL or other ocular device has the potential to impact so many patients around the world – many more patients than I could help as an ophthalmologist. Also, it’s great to be able to significantly help our colleagues when they face some unknown complication for which we have already performed studies evaluating its natural history and preventative measures.
I believe we can have a general life plan, but we have to remain open to unexpected opportunities. Many times we think we really want something, and then an opportunity to do something else shows up, and we can be very pleasantly surprised! We are the happiest when we discover what we really like to do, whatever that might be, and in my case that is research. There is no work that is unimportant, and it is great that we are all different so we can complement each other!
