ALL IN THE FAMILY

ALL IN THE FAMILY
Arthur Cummings
Published: Thursday, January 29, 2015

The founder of the Barraquer family of ophthalmologists was José Antonio Barraquer Roviralta (1852-1924), who graduated from medical studies at the University of Barcelona in 1877 and became a PhD in Madrid. 
He then devoted himself to studying histology and collaborated with Santiago Ramón y Cajal. His many histological studies contributed to topographical anatomy and histopathological studies, mostly based on eye injuries.
Some of his museum pieces of ocular anatomy and pathology are preserved and deposited in the Centro de Oftalmología Barraquer in Barcelona. Later he was trained in ophthalmology in Paris, under Ksawery Galezowski (1832-1907) and Louis de Wecker (1832-1906). 
After returning to Barcelona, he opened an ophthalmic clinic at the old Hospital de la Santa Cruz, where he worked from 1880 to 1890. At that time, it was decided to introduce ophthalmology teaching to medical schools, and he was proposed as the professor of ophthalmology. 
In 1903 he founded the Ophthalmological Society of Barcelona, and edited two Spanish ophthalmic journals. His brother Lluis Barraquer Roviralta (1855-1928) was a pioneer of neurology in Spain, and was the first to describe progressive lipodystrophy, also known as Barraquer’s Syndrome.
The son of Jose Antonio, Ignacio Barraquer (1884-1965), was also born in Barcelona, where he studied medicine and earned degrees in both his BA in 1907 and his PhD in 1908. 
While still a student, he completed two important works on Dacryocystitis of the newborn and tuberculosis of the iris. Later he worked at the Holy Cross Hospital in Barcelona, as an assistant and later an assistant professor in the University Chair of Ophthalmology and after his father retired, as his successor. 
In 1947 he founded the Barraquer Institute in Barcelona, which soon became one of the world’s best ophthalmology centres. This private centre has organised postgraduate courses, conducted experimental and clinical research, produced scientific and educational films and published ophthalmologic literature. 
Ignacio Barraquer is best remembered for his idea of extracting the cataract by applying a vacuum or suction cup (1917) with much less damage than other techniques used at that time.
He also designed the necessary instruments, built up the sucking cup and the vacuum-producing mechanical device producing adjustable vacuum to facilitate the extraction of the crystalline lens, and proved the effectiveness of the procedure.

AQUARIUM 
Ignacio confirmed that the idea was the result of observation of his aquarium, while watching how a leech apprehended a pebble from the bottom: “If I could catch the human eye lens in the same way that a leech moving it picks up a pebble and moves it along the aquarium without moving any water, the pneumatic suction produced by the sucking cup would break the fibres of the zonule - ligament by which the lens remains fixed - and this way I could gently draw out the cataract with minimal trauma." 
The invention brought him and the Barraquer Institute in Barcelona international recognition and patients from all over the world,  ensuring he deserved the epithet “Universal Catalan”.
His most famous patient operated on with this technique was Eugenia de Montijo, Empress of France, wife of Napoleon III. He also influenced numerous original techniques (eg dacryocystorhinostomy, sclerotomy, reconstruction of the orbital cavity, strabismus surgery,  sclera-iridectomy etc), and developed many surgical instruments (eg sclerotome, forceps for iridectomy, keratoplasty instruments etc).
With his wife Josefa Moner, they had seven children, of whom two, José Ignacio and Joaquín, entered the world of ophthalmology. The eldest son, Jose Ignacio Barraquer Moner (1916-1998), settled in Bogotá in 1953 after specialisation in ophthalmology, where he founded the Barraquer Institute of America in 1964. 
His name is best known for his works on keratoplasty and his idea and development of keratomileusis, keratophakia and introducing the refractive surgery to ophthalmology. 
Joaquín Barraquer Moner (1927-), Professor of Eye Surgery at the Universitat Autònoma de Barcelona (UAB) and director of the Institut Universitari Barraquer (affiliated to the UAB), in 1957 discovered the action alpha-chymotrypsin on the human zonule and developed the technique of “enzymatic zonulolysis”, a surgical procedure that significantly facilitated the extraction of the cataract. 
He also introduced many other developments to ophthalmology, including a new type of microscope and several types of intraocular lenses. Now, the Barraquer dynasty in Barcelona is continued by Joaquín Barraquer’s daughter Elena and his son Raphael, as well as his son’s wife Marinka Kargachin.
*     Andrzej Grzybowski MD, PhD, MBA, Professor of Ophthalmology; Chair of Ophthalmology, University of Warmia and Mazury, Olsztyn, Poland

Tags: macular degeneration
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