Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 77
Filtrar
Más filtros

Banco de datos
País/Región como asunto
Tipo del documento
País de afiliación
Intervalo de año de publicación
1.
Exp Eye Res ; 224: 109232, 2022 11.
Artículo en Inglés | MEDLINE | ID: mdl-36055389

RESUMEN

Non-invasive imaging techniques are increasingly used to objectively quantify anterior segment structures of the eye. In this study, we apply the novel oxygen delivery index (ODIN) concept that, quantifies microvascular capacity for oxygen delivery, to the ocular surface in healthy humans. The purpose of the study was to test the applicability of the technologies used for data acquisition from the human ocular surface. We also validated whether the ODIN concept has sufficient sensitivity to detect and differentiate between microvascular structure and function in limbal and bulbar conjunctiva. Multiple ocular surface measurements using computer-assisted video microscopy (field of view: 1.6 mm × 0.9 mm) and diffuse reflectance spectroscopy (measuring volume: ∼0.1 mm3) were obtained from limbal and bulbar conjunctiva in 20 healthy volunteers. Three parameters were extracted during analyses: Functional capillary density, capillary flow velocity, and microvascular oxygen saturation. Functional capillary density was higher at limbus than in bulbar conjunctiva (11.2 ± 1.8 c/mm versus 5.2 ± 1.2 c/mm, p < 0.01), and microvascular oxygen saturation was lower at limbus (77 ± 8%) as compared to bulbar conjunctiva (89 ± 6%), p < 0.01. More than 80% of scored capillaries had continuous blood flow and no difference was seen between the recording sites (p = 0.68). In conclusion, the ODIN concept is applicable for the assessment of human ocular surface microvascular function and has sufficient sensitivity to detect increased capillary density and oxygen extraction at limbus as compared with bulbar conjunctiva.


Asunto(s)
Conjuntiva , Oxígeno , Humanos , Microcirculación/fisiología , Microscopía por Video , Conjuntiva/irrigación sanguínea , Análisis Espectral , Computadores
2.
Artif Organs ; 46(5): 786-793, 2022 May.
Artículo en Inglés | MEDLINE | ID: mdl-34866193

RESUMEN

BACKGROUND: Non-pulsatile cardiopulmonary bypass (CPB) may induce microvascular dysregulation. In piglets, we compared ocular surface microcirculation during pulsatile versus continuous flow (CF) bypass. METHODS: Ocular surface microcirculation in small tissue volumes (~0.1 mm3 ) at limbus (high metabolic rate) and bulbar conjunctiva (low metabolic rate) was examined in a porcine model using computer assisted video microscopy and diffuse reflectance spectroscopy, before and after 3 and 6 h of pulsatile (n = 5 piglets) or CF (n = 3 piglets) CPB. Functional capillary density, capillary flow velocity and microvascular oxygen saturation were quantified. RESULTS: At limbus, velocities improved with pulsatility (p < 0.01) and deteriorated with CF (p < 0.01). In bulbar conjunctiva, velocities were severely reduced with CF (p < 0.01), accompanied by an increase in capillary density (p < 0.01). Microvascular oxygen saturation decreased in both groups. CONCLUSION: Ocular surface capillary densities and flow patterns are better preserved with pulsatile versus CF during 6 h of CPB in sleeping piglets.


Asunto(s)
Puente Cardiopulmonar , Conjuntiva , Animales , Puente Cardiopulmonar/efectos adversos , Puente Cardiopulmonar/métodos , Microcirculación , Flujo Pulsátil/fisiología , Porcinos
3.
Tidsskr Nor Laegeforen ; 141(9)2021 06 08.
Artículo en Inglés, Noruego | MEDLINE | ID: mdl-34107671

RESUMEN

BACKGROUND: Cataract surgery is a very common intervention. The objective of this study was to investigate the trends in the number of cataract surgeries in Norway and the characteristics of patients who underwent cataract surgery in the period 2010-19. MATERIAL AND METHOD: Data on cataract surgery were collected from the Norwegian Patient Registry. The number of cataract surgeries per million inhabitants was calculated on the basis of population data from Statistics Norway. RESULTS: The number of cataract surgeries in Norway increased from 36 340 in 2010 to 48 291 in 2019. This corresponded to an increase of 21 %, from 7 480 to 9 063 per million inhabitants respectively, in the same period. The average age was 74 years, and more than 90 % of the patients were above the age of 60. The proportion of cataract surgeries among patients older than 60 years remained virtually unchanged through the study period. Women accounted for 60 % of the cataract surgeries in 2010 and 57 % in 2019. The proportion of surgeries performed by contract specialists in the entire period varied from 32 % in Central Norway Regional Health Authority to 62 % in Northern Norway Regional Health Authority. INTERPRETATION: The number of cataract surgeries increased throughout the period in pace with the population growth in the age group above 60 years. With further population growth and an increasing number of older people, planning for a further increase in the number of cataract surgeries in future years is likely to be required.


Asunto(s)
Extracción de Catarata , Catarata , Anciano , Catarata/epidemiología , Femenino , Predicción , Humanos , Persona de Mediana Edad , Noruega/epidemiología
4.
Exp Eye Res ; 201: 108312, 2020 12.
Artículo en Inglés | MEDLINE | ID: mdl-33157128

RESUMEN

In piglets we tested the applicability of digital video microscopy and diffuse reflectance spectroscopy for non-invasive assessments of limbal and bulbar conjunctival microcirculation. A priori we postulated that the metabolic rate is higher in limbal as compared to bulbar conjunctiva, and that this difference is reflected in microvascular structure or function between the two locations. Two study sites, Oslo University Hospital (OUH), Norway and Cleveland Clinic (CC), USA, used the same video microscopy and spectroscopy techniques to record limbal and bulbar microcirculation in sleeping piglets. Recordings were analyzed with custom-made software to quantify functional capillary density, capillary flow velocity and microvascular oxygen saturation in measuring volumes of approximately 0.1 mm3. The functional capillary density was higher in limbus than in bulbar conjunctiva at both study sites (OUH: 18.1 ± 2.9 versus 12.2 ± 2.9 crossings per mm line, p < 0.01; CC: 11.3 ± 3.0 versus 7.1 ± 2.8 crossings per mm line, p < 0.01). Median categorial capillary blood flow velocity was higher in bulbar as compared with limbal recordings (CC: 3 (1-3) versus 1 (0-3), p < 0.01). Conjunctival microvascular oxygen saturation was 88 ± 5.9% in OUH versus 94 ± 7.5% in CC piglets. Non-invasive digital video microscopy and diffuse reflectance spectroscopy can be used to obtain data from conjunctival microcirculation in piglets. Limbal conjunctival microcirculation has a larger capacity for oxygen delivery as compared with bulbar conjunctiva.


Asunto(s)
Velocidad del Flujo Sanguíneo/fisiología , Conjuntiva/irrigación sanguínea , Procesamiento de Imagen Asistido por Computador/métodos , Microcirculación/fisiología , Microscopía por Video/métodos , Microvasos/fisiología , Análisis Espectral/métodos , Animales , Femenino , Masculino , Modelos Anatómicos , Modelos Animales , Porcinos
5.
Am J Med Genet A ; 182(2): 397-408, 2020 02.
Artículo en Inglés | MEDLINE | ID: mdl-31825148

RESUMEN

The age-dependent penetrance of organ manifestations in Marfan syndrome (MFS) is not known. The aims of this follow-up study were to explore how clinical features change over a 10-year period in the same Norwegian MFS cohort. In 2003-2004, we investigated 105 adults for all manifestations in the 1996 Ghent nosology. Ten years later, we performed follow-up investigations of the survivors (n = 48) who consented. Forty-six fulfilled the revised Ghent criteria. Median age: females 51 years, range 32-80 years; males 45 years, range 30-67 years. New aortic root dilatation was detected in patients up to 70 years. Ascending aortic pathology was diagnosed in 93 versus 72% at baseline. Sixty-five percent had undergone aortic surgery compared to 39% at baseline. Pulmonary trunk mean diameter had increased significantly compared to baseline. From inclusion to follow-up, two patients (three eyes) developed ectopia lentis, four developed dural ectasia, four developed scoliosis, three developed incisional or recurrent herniae, and 14 developed hindfoot deformity. No changes were found regarding protrusio acetabuli, spontaneous pneumothorax, or striae atrophicae. The study confirms that knowledge of incidence and progression of organ manifestations throughout life is important for diagnosis, treatment, and follow-up of patients with verified or suspected MFS.


Asunto(s)
Aorta/fisiopatología , Hernia/diagnóstico , Síndrome de Marfan/epidemiología , Escoliosis/diagnóstico , Adulto , Factores de Edad , Anciano , Anciano de 80 o más Años , Aorta/cirugía , Dilatación Patológica/diagnóstico , Dilatación Patológica/fisiopatología , Desplazamiento del Cristalino/diagnóstico , Desplazamiento del Cristalino/fisiopatología , Femenino , Estudios de Seguimiento , Hernia/fisiopatología , Humanos , Masculino , Síndrome de Marfan/diagnóstico , Síndrome de Marfan/fisiopatología , Persona de Mediana Edad , Escoliosis/fisiopatología
6.
Tidsskr Nor Laegeforen ; 140(7)2020 05 05.
Artículo en Inglés, Noruego | MEDLINE | ID: mdl-32378840

RESUMEN

BACKGROUND: Cataract surgery with implantation of an artificial intraocular lens (IOL) in the lens capsule ('in-the-bag') is one of the world's most common surgeries. After many years, this IOL capsule complex may dislocate. This condition, called late in-the-bag IOL dislocation, has an estimated incidence of 0.5-1 %, with increasing frequency. CASE PRESENTATION: A man in his late seventies presented with monocular decreased vision and high intraocular pressure. Pupil dilation revealed the diagnosis of late in-the-bag IOL dislocation. Surgery was performed with repositioning of the dislocated complex by scleral suturing. The patient's visual acuity normalised after surgery. INTERPRETATION: Late in-the-bag IOL dislocation is no longer a rare condition. It requires surgery, which may be performed either as repositioning of the dislocated complex or by exchanging it for a new IOL. Both operation methods give a good visual outcome.


Asunto(s)
Cápsula del Cristalino , Lentes Intraoculares , Humanos , Masculino , Complicaciones Posoperatorias/etiología , Complicaciones Posoperatorias/cirugía , Reoperación , Estudios Retrospectivos
7.
Optom Vis Sci ; 96(5): 362-366, 2019 05.
Artículo en Inglés | MEDLINE | ID: mdl-31046019

RESUMEN

SIGNIFICANCE: Our study suggests that patients would benefit from adjusting their distance spectacles several years after cataract surgery. This may lead to a better quality of life for these patients. PURPOSE: The purpose of this study was to determine whether patients' distance vision is optimally corrected with spectacles 6 to 7 years after cataract surgery and whether patients with glaucoma who regularly visit an ophthalmologist have more correct power in their spectacles. METHODS: A total of 153 patients (153 eyes) who underwent cataract surgery with phacoemulsification at Oslo University Hospital were examined 6 to 7 years after surgery. Patients with better or equal best-corrected distance visual acuity in the study eye compared with the other eye were included (n = 90; 59%). Vision-related outcomes were measured and analyzed, including a modified version of the visual function questionnaire, Visual Function-14 (VF-14). RESULTS: A significant difference was found in the logMAR score between the patients' habitual correction (if any) and those with best-corrected distance visual acuity measured at the postoperative study examination (0.20 ± 0.40 and 0.10 ± 0.39, respectively; P < .0001). Patients with glaucoma (n = 17) did not have more correct power of their spectacles than did patients without glaucoma (n = 73; P = .38). The overall mean VF-14 score was 89%, with a statistically significant correlation between a high VF-14 score and a good habitual distance correction (r = -0.82; P < .0001). CONCLUSIONS: This study indicates that, although the patients are quite satisfied with their visual function 6 to 7 years after cataract surgery, many patients are not making the most of their visual potential. Thus, there seems to be a need for better monitoring of patients' distance refraction and spectacle use for an extended period after cataract surgery.


Asunto(s)
Anteojos/estadística & datos numéricos , Implantación de Lentes Intraoculares , Facoemulsificación , Errores de Refracción/rehabilitación , Agudeza Visual/fisiología , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Masculino , Seudofaquia/fisiopatología , Calidad de Vida , Errores de Refracción/fisiopatología , Encuestas y Cuestionarios , Factores de Tiempo
8.
Clin Exp Ophthalmol ; 47(2): 212-218, 2019 03.
Artículo en Inglés | MEDLINE | ID: mdl-30260057

RESUMEN

IMPORTANCE: Long-term follow-up of Marfan syndrome (MFS) patients. BACKGROUND: Investigate changes in ocular features in MFS patients fulfilling the Ghent-2 criteria following a period of 10 years. DESIGN: Repeated cross-sectional study with two observations. PARTICIPANTS: Eighty-four MFS patients were investigated in 2003-2004 (baseline). Forty-four of these patients (52%) were examined after 10 years. METHODS: A comprehensive ocular examination performed at baseline and follow-up. MAIN OUTCOME MEASURES: Development or progression of ectopia lentis (EL). RESULTS: At follow-up, mean age was 50.1 ± 11.9 years (range: 30-80 years), 74% were female and 70% of the patients were diagnosed with EL compared to 66% at baseline. Two patients (3 eyes) had developed EL over the decade, representing a 13% risk. Furthermore, one eye had progressed from a subtle tilt of the lens to dislocation. We found no significant change in the axial length (P = 0.96), the corneal curvature (P = 0.64) or the spherical equivalent (P = 0.23). Best corrected visual acuity was improved at follow-up (P = 0.02). There were 7% and 33% risks for development of retinal detachment and cataract between baseline and follow-up, respectively. CONCLUSIONS AND RELEVANCE: Our study indicates that even though EL typically occurs at an early stage in most MFS patients, there is still a risk of developing EL in adulthood. The risk of developing vision-threatening complications such as retinal detachment and cataract was much higher than in the normal population, but even so, the visual potential of the MFS patients was relatively good.


Asunto(s)
Catarata/diagnóstico , Desplazamiento del Cristalino/diagnóstico , Síndrome de Marfan/diagnóstico , Desprendimiento de Retina/diagnóstico , Adulto , Anciano , Anciano de 80 o más Años , Longitud Axial del Ojo/patología , Córnea/patología , Estudios Transversales , Progresión de la Enfermedad , Femenino , Estudios de Seguimiento , Humanos , Masculino , Persona de Mediana Edad , Agudeza Visual/fisiología
9.
Ophthalmology ; 124(2): 151-159, 2017 02.
Artículo en Inglés | MEDLINE | ID: mdl-27914839

RESUMEN

PURPOSE: To compare the efficacy and safety of 2 operation methods for late in-the-bag intraocular lens (IOL) dislocation. DESIGN: Prospective, randomized, parallel-group surgical trial. PARTICIPANTS: Patients referred to Oslo University Hospital (tertiary referral center). METHODS: We randomly assigned 104 patients (104 eyes) either to IOL repositioning by scleral suturing (n = 54) or to IOL exchange with retropupillary fixation of an iris-claw IOL (n = 50). One surgeon performed all operations. Patients were evaluated comprehensively before surgery, and most patients (82%) attended an examination 6 months after surgery. MAIN OUTCOME MEASURES: Best-corrected visual acuity (BCVA) 6 months after surgery. RESULTS: The mean postoperative BCVA was 0.24±0.29 logarithm of the minimum angle of resolution (logMAR) units (range, -0.18 to 1.16 logMAR) in the repositioning group and 0.35±0.54 logMAR (range, -0.20 to 3.0 logMAR) in the exchange group (P = 0.23). A BCVA of 20/40 or better (Snellen) was reached by 61% and 62% of the patients, respectively (P = 0.99). The mean postoperative corneal cylinder was 1.2±1.0 and 1.2±0.8 diopters, respectively (P = 0.84), and the postoperative endothelial cell density changes were -3±10% (P = 0.07) and -10±14% (P = 0.001), respectively (group difference, P = 0.04). Repositioning had a longer mean surgical time than exchange (P < 0.001). There were 2 (4%) and 0 cases of perioperative fluid misdirection syndrome, respectively. Postoperative complications were intraocular pressure (IOP) increase (n = 12), cystoid macular edema (CME; n = 3), and nonarteritic anterior ischemic optic neuropathy (n = 1) in the repositioning group, and IOP increase (n = 9), pupillary block (n = 1), choroidal effusion (n = 2), CME (n = 4), and redislocation (n = 1) in the exchange group. CONCLUSIONS: We found satisfactory and not significantly different outcomes for BCVA 6 months after surgery in the 2 groups. Both operation methods seemed safe, with low frequencies of serious perioperative and postoperative complications. However, some of the observed differences in complications should be taken into consideration when selecting the most suitable method in clinical practice.


Asunto(s)
Migracion de Implante de Lente Artificial/cirugía , Implantación de Lentes Intraoculares/métodos , Lentes Intraoculares , Anciano , Anciano de 80 o más Años , Recuento de Células , Células Endoteliales/citología , Femenino , Humanos , Iris/cirugía , Cristalino/cirugía , Masculino , Persona de Mediana Edad , Estudios Prospectivos , Esclerótica/cirugía , Técnicas de Sutura , Agudeza Visual
10.
Exp Eye Res ; 153: 122-132, 2016 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-27702552

RESUMEN

Patients with limbal stem cell deficiency (LSCD) often experience pain and photophobia due to recurrent epithelial defects and chronic inflammation of the cornea. Successfully restoring a healthy corneal surface in these patients by transplantation of ex vivo expanded human limbal epithelial cells (LECs) may alleviate these symptoms and significantly improve their quality of life. The clinical outcome of transplantation is known to be influenced by the quality of transplanted cells. Presently, several different protocols for cultivation and transplantation of LECs are in use. However, no consensus on an optimal protocol exists. The aim of this study was to examine the effect of culture medium and carrier on the morphology, staining of selected keratins and global gene expression in ex vivo cultured LECs. Limbal biopsies from cadaveric donors were cultured for three weeks on human amniotic membrane (HAM) or on tissue culture coated plastic (PL) in either a complex medium (COM), containing recombinant growth factors, hormones, cholera toxin and fetal bovine serum, or in medium supplemented only with human serum (HS). The expanded LECs were examined by light microscopy (LM), transmission electron microscopy (TEM), immunohistochemistry (IHC) for keratins K3, K7, K8, K12, K13, K14, K15 and K19, as well as microarray and qRT-PCR analysis. The cultured LECs exhibited similar morphology and keratin staining on LM, TEM and IHC examination, regardless of the culture condition. The epithelium was multilayered, with cuboidal basal cells and flattened superficial cells. Cells were attached to each other by desmosomes. Adhesion complexes were observed between basal cells and the underlying carrier in LECs cultured on HAM, but not in LECs cultured on PL. GeneChip Human Gene 2.0 ST microarray (Affymetrix) analysis revealed that 18,653 transcripts were ≥2 fold up or downregulated (p ≤ 0.05). Cells cultured in the same medium (COM or HS) showed more similarities in gene expression than cells cultured on the same carrier (HAM or PL). When each condition was compared to HAM/COM, no statistical difference was found in the transcription level of the selected genes associated with keratin expression, stemness, proliferation, differentiation, apoptosis, corneal wound healing or autophagy. In conclusion, the results indicate that ex vivo cultures of LECs on HAM and PL, using culture media supplemented with COM or HS, yield tissues with similar morphology and keratin staining. The gene expression appears to be more similar in cells cultured in the same medium (COM or HS) compared to cells cultured on the same carrier (HAM or PL).


Asunto(s)
Trasplante de Córnea , Epitelio Corneal/metabolismo , Regulación de la Expresión Génica , Queratinas/genética , Limbo de la Córnea/ultraestructura , ARN/genética , Anciano , Biopsia , Células Cultivadas , Enfermedades de la Córnea/genética , Enfermedades de la Córnea/patología , Enfermedades de la Córnea/cirugía , Medios de Cultivo , Epitelio Corneal/ultraestructura , Femenino , Humanos , Inmunohistoquímica , Queratinas/biosíntesis , Limbo de la Córnea/metabolismo , Masculino , Microscopía Electrónica de Transmisión , Persona de Mediana Edad , Reacción en Cadena en Tiempo Real de la Polimerasa
12.
Acta Ophthalmol ; 102(3): 306-311, 2024 May.
Artículo en Inglés | MEDLINE | ID: mdl-37303305

RESUMEN

PURPOSE: To investigate the inflammatory reaction in eyes with late in-the-bag intraocular lens (IOL) dislocation. METHODS: This prospective clinical study with fellow-eye comparison consists of 76 of the patients (76 eyes) with late in-the-bag IOL dislocation enrolled in the LION trial. The main outcome measure was anterior chamber flare before surgery measured with a laser flare meter in photon counts per millisecond (pc/ms). The dislocation was graded as 1 (small: optic still covering the visual axis), 2 (optic equator close to the visual axis) or 3 (optic decentred beyond the visual axis, but the IOL-capsule complex partly visible in the pupillary area). The secondary aim was to compare intraocular pressure (IOP) before surgery. RESULTS: Flare levels before surgery were significantly higher in the dislocation eyes than in the fellow eyes with a median flare of 21.5 (range 5.4-135.7) pc/ms versus 14.1 (2.0-42.9) pc/ms, respectively (p ˂ 0.001). A regression analysis of log-transformed flare values showed that the dislocation eyes had a non-significant tendency towards higher flare in dislocation grade 1 with a median flare of 24.6 (5.4-135.7) pc/ms compared to grade 2; 19.6 (6.5-41.5) pc/ms (p = 0.06), and no significant difference compared to grade 3; 19.4 (10.2-53.5) pc/ms (p = 0.47). The IOP was significantly higher in the dislocation eyes than in the fellow eyes (p ˂ 0.001). CONCLUSIONS: Eyes with late in-the-bag IOL dislocation had increased flare levels compared to their fellow eyes. This suggests that inflammation is part of the clinical picture of late in-the-bag IOL dislocation.


Asunto(s)
Oftalmopatías , Subluxación del Cristalino , Lentes Intraoculares , Humanos , Lentes Intraoculares/efectos adversos , Estudios Prospectivos , Complicaciones Posoperatorias/cirugía , Inflamación/diagnóstico , Inflamación/etiología , Subluxación del Cristalino/cirugía
13.
Cornea ; 43(4): 437-442, 2024 Apr 01.
Artículo en Inglés | MEDLINE | ID: mdl-37851565

RESUMEN

PURPOSE: The aim of this study was to investigate the effect of the implementation of corneal collagen crosslinking (CXL) on the frequency of corneal transplants among patients with keratoconus (KC) in the same region. METHODS: Before the introduction of CXL in 2007, 55 primary corneal transplants had been conducted in patients with KC (2005 and 2006) at the Department of Ophthalmology, Oslo University Hospital, Norway. We collected data from our corneal transplant registry for 2021 and 2022. The primary outcome was the number of corneal transplants performed in patients with KC. Age, sex, visual acuity (logarithm of the minimal angle of resolution), KC stage according to the Amsler-Krumeich classification system, and steepest keratometry reading (maximum keratometry, Pentacam, HR) were recorded. Furthermore, we registered the annual number of CXL treatments conducted from 2007 to 2022. RESULTS: A total of 352 corneal transplants were performed in 2021 and 2022. Among them, 11 (3.1%) were transplants for patients with KC. All included patients were male; further, 90.1% and 9.1% of the patients were graded stages 4 and 3, respectively. The mean maximum keratometry was 79.0 diopter (range 61.0-109). The mean best-corrected visual acuity (logarithm of the minimal angle of resolution) was 1.3 (range 0.2-3.0). In 2021 to 2022, 431 CXL treatments were performed. CONCLUSIONS: There was a significant decrease in the number of corneal transplants performed in patients with KC 15 years after the introduction of CXL. This indicates that the availability of CXL treatment over many years may considerably reduce the need for keratoplasties in this group of patients.


Asunto(s)
Trasplante de Córnea , Queratocono , Fotoquimioterapia , Humanos , Masculino , Femenino , Queratocono/tratamiento farmacológico , Queratocono/cirugía , Fármacos Fotosensibilizantes/uso terapéutico , Topografía de la Córnea , Reactivos de Enlaces Cruzados/uso terapéutico , Colágeno/uso terapéutico , Riboflavina/uso terapéutico , Rayos Ultravioleta
14.
Acta Ophthalmol ; 102(2): 186-191, 2024 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-37340695

RESUMEN

PURPOSE: A comparison of the safety and efficacy of the MicroShunt versus trabeculectomy in the early postoperative period, with a particular focus on hypotony. METHODS: In this registry study, we evaluated 200 eyes of 200 glaucoma patients who underwent filtration surgery at Oslo University Hospital between 2017 and 2021. Of these patients, 100 had a Preserflo MicroShunt (Santen) implantation and 100 had a trabeculectomy procedure. The patients were examined per standard hospital protocol after filtration surgery. Data were extracted from the 4- and 8-week visits. We defined hypotony as intraocular pressure (IOP) < 6 mmHg. RESULTS: The mean preoperative IOP was 20.6 ± 7.1 mmHg in the MicroShunt group and 21.6 ± 7.1 mmHg in the trabeculectomy group, and the patients used a mean of 3.0 ± 0.9 and 3.1 ± 0.9 glaucoma medications, respectively. After 8 weeks, IOP was reduced to 10.4 ± 5.4 mmHg and 11.3 ± 4.6 mmHg, respectively (p = 0.23). During the early postoperative period, hypotony was registered in 63% of the MicroShunt patients and in 21% of the patients in the trabeculectomy group (p < 0.001); and 11% and 1%, respectively, of the patients developed choroidal detachments (p < 0.003). One patient in the MicroShunt group required reoperation due to hypotony. CONCLUSIONS: In this registry study, we found that the Preserflo MicroShunt and trabeculectomy had equally satisfactory IOP-lowering effects during the early postoperative period. In this same period, a high number of patients in the MicroShunt group developed hypotony.


Asunto(s)
Glaucoma , Trabeculectomía , Humanos , Trabeculectomía/métodos , Glaucoma/cirugía , Presión Intraocular , Ojo , Periodo Posoperatorio , Estudios Retrospectivos , Resultado del Tratamiento
15.
Acta Ophthalmol ; 101(6): 636-643, 2023 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-36808711

RESUMEN

PURPOSE: The aim of this study was to evaluate the intra- and postoperative complications, especially the risk of visual axis opacification (VAO), following the implantation of the bag-in-the-lens (BIL) intraocular lens (IOL) in infants with congenital cataract operated on before 12 weeks of age. METHODS: Infants operated on before 12 weeks of age between June 2020 and June 2021 with a follow-up longer than 1 year were included in the present retrospective study. This was a first-experience cohort of an experienced paediatric cataract surgeon with this type of lens. RESULTS: Nine infants (13 eyes) with a median age at surgery of 28 days (range, 21-49 days) were included. The median follow-up time was 21.6 months (range, 12.2-23.4 months). The lens was correctly implanted with the anterior and posterior capsulorhexis edges placed into the interhaptic groove of the BIL IOL in seven of 13 eyes; none of these eyes developed VAO. In the remaining six eyes, the IOL was only fixated to the anterior capsulorhexis edge, and in these cases, an anatomical anomaly of the posterior capsule and/or anterior vitreolenticular interface dysgenesis were observed. These six eyes developed VAO. One eye had a partial iris capture in the early postoperative phase. Otherwise, the IOL remained well centred and stable in all eyes. Anterior vitrectomy was necessary in seven eyes due to vitreous prolapse. One patient with unilateral cataract was diagnosed with bilateral primary congenital glaucoma at 4 months of age. CONCLUSION: Implantation of the BIL IOL is safe even in the youngest age group less than 12 weeks of age. Although being a first-experience cohort, the BIL technique is shown to reduce the risk of VAO and the number of surgical procedures.


Asunto(s)
Extracción de Catarata , Catarata , Cristalino , Lentes Intraoculares , Niño , Lactante , Humanos , Recién Nacido , Implantación de Lentes Intraoculares/métodos , Estudios Retrospectivos , Estudios de Seguimiento , Cristalino/cirugía , Catarata/diagnóstico , Complicaciones Posoperatorias/epidemiología
16.
Cells ; 12(5)2023 02 24.
Artículo en Inglés | MEDLINE | ID: mdl-36899873

RESUMEN

We aimed to investigate whether a novel technique of human amniotic membrane (HAM) preparation that mimics the crypts in the limbus enhances the number of progenitor cells cultured ex vivo. The HAMs were sutured on polyester membrane (1) standardly, to obtain a flat HAM surface, or (2) loosely, achieving the radial folding to mimic crypts in the limbus. Immunohistochemistry was used to demonstrate a higher number of cells positive for progenitor markers p63α (37.56 ± 3.34% vs. 62.53 ± 3.32%, p = 0.01) and SOX9 (35.53 ± 0.96% vs. 43.23 ± 2.32%, p = 0.04), proliferation marker Ki-67 (8.43 ± 0.38 % vs. 22.38 ± 1.95 %, p = 0.002) in the crypt-like HAMs vs. flat HAMs, while no difference was found for the quiescence marker CEBPD (22.99 ± 2.96% vs. 30.49 ± 3.33 %, p = 0.17). Most of the cells stained negative for the corneal epithelial differentiation marker KRT3/12, and some were positive for N-cadherin in the crypt-like structures, but there was no difference in staining for E-cadherin and CX43 in crypt-like HAMs vs. flat HAMs. This novel HAM preparation method enhanced the number of progenitor cells expanded in the crypt-like HAM compared to cultures on the conventional flat HAM.


Asunto(s)
Amnios , Células Madre , Humanos , Inmunohistoquímica
17.
Exp Eye Res ; 97(1): 1-9, 2012 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-22342952

RESUMEN

In patients with limbal stem cell deficiency (LSCD), transplantation of ex vivo expanded human limbal epithelial cells (HLECs) can restore the structural and functional integrity of the corneal surface. However, the protocol for cultivation and transplantation of HLECs differ significantly, and in most protocols growth additives such as cholera toxins, exogenous growth factors, hormones and fetal calf serum are used. In the present article, we compare for the first time human limbal epithelial cells (HLECs) cultivated on human amniotic membrane (HAM) in a complex medium (COM) including fetal bovine serum to a medium with human serum as single growth supplement (HSM), and report on our first examinations of HLECs expanded in autologous HSM and used for transplant procedures in patients with LSCD. Expanded HLECs were examined by genome-wide microarray, RT-PCR, Western blotting, and for cell viability, morphology, expression of immunohistochemical markers and colony forming efficiency. Cultivation of HLECs in HSM produced a multilayered epithelium where cells with markers associated with LESCs were detected in the basal layers. There were few transcriptional differences and comparable cell viability between cells cultivated in HSM and COM. The p63 gene associated with LESCs were expressed 3.5 fold more in HSM compared to COM, and Western blotting confirmed a stronger p63α band in HSM cultures. The cornea-specific keratin CK12 was equally found in both culture conditions, while there were significantly more CK3 positive cells in HSM. Cells in epithelial sheets on HAM remaining after transplant surgery of patients with LSCD expressed central epithelial characteristics, and dissociated cells cultured at low density on growth-arrested fibroblasts produced clones containing 21 ± 12% cells positive for p63α (n = 3). In conclusion, a culture medium without growth additives derived from animals or from animal cell cultures and with human serum as single growth supplement may serve as an equivalent replacement for the commonly used complex medium for ex vivo expansion of HLECs on HAM.


Asunto(s)
Amnios , Células Epiteliales/citología , Limbo de la Córnea/citología , Células Madre/citología , Andamios del Tejido , Animales , Biomarcadores/metabolismo , Sangre , Western Blotting , Bovinos , Técnicas de Cultivo de Célula , Supervivencia Celular , Medios de Cultivo , Células Epiteliales/metabolismo , Perfilación de la Expresión Génica , Estudio de Asociación del Genoma Completo , Humanos , Inmunohistoquímica , Queratina-12/genética , Queratina-12/metabolismo , Limbo de la Córnea/metabolismo , Análisis de Secuencia por Matrices de Oligonucleótidos , Reacción en Cadena en Tiempo Real de la Polimerasa , Albúmina Sérica , Células Madre/metabolismo , Factores de Transcripción/genética , Factores de Transcripción/metabolismo , Proteínas Supresoras de Tumor/genética , Proteínas Supresoras de Tumor/metabolismo
18.
Clin Ophthalmol ; 16: 2775-2780, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-36039107

RESUMEN

Objective: In eyes with severe corneal pathology, biometric measurements of the corneal curvature (K) can be challenging. The aims of this study were to test whether K mean values from the fellow eye can be used as substitute in lens power calculations and to determine if similarity in axial length (AL) in a patient's two eyes implies similarity also in the corneal curvature. Methods and Analysis: A retrospective study of optical biometry measurements in 500 adults (1000 phakic eyes) that was scheduled for cataract surgery. Inclusion criteria were complete recordings of all parameters in both eyes and a signal-to-noise ratio of at least 10. Similar AL was defined as less than 0.3 mm difference between the patient's two eyes. Results: The IOL power calculated with K mean from the fellow eye was 0.39 D (standard deviation (SD) 0.57) different from the calculation with both AL and K mean from the correct eye. The difference was larger than 1.0 D in 26 (5%) eyes. In patients with similar AL in their two eyes (n = 372), the interocular difference in K mean was 0.43 D (SD 0.67 D), compared to 0.45 D (SD 0.49 D) for the patients with an AL difference of 0.3 mm or more (n = 128) (p = 0.81). Conclusion: Lens calculations with keratometry values from the fellow eye as substitute yielded quite similar results as calculations with the correct values. Hence, this seems to be an acceptable approach in patients with incomplete keratometry recordings. Similarity in AL between a person's two eyes did not imply more similar corneal curvatures.

19.
Acta Ophthalmol ; 100(5): 526-533, 2022 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-35411695

RESUMEN

PURPOSE: The aim of this study was to report visual outcome and safety after cataract surgery with primary intraocular lens implantation before 12 weeks of age. METHODS: Infants with visually significant unilateral congenital cataract having primary IOL implantation in the capsular bag before 12 weeks of age in 2007-2016 were enrolled for a prospective study examination in 2017. The medical records were also reviewed. RESULTS: In total, 23 patients with a median age at cataract surgery of 32 days (range, 12-75 days) were included. Seventeen (74%) eyes had persistent foetal vasculature (PFV). After a median follow-up of 6.3 years (range, 1.4-10.9 years), the corrected distance visual acuity was 0.8 logMAR (range, 3.0-0.1 logMAR). All, except one eye, required surgery for visual axis opacification (VAO), with a median of two (range 0-5) additional surgical procedures. Four (17%) eyes developed secondary glaucoma. CONCLUSION: Cataract surgery with primary IOL implantation before 12 weeks of age resulted in a high number of VAO operations, and the visual outcome varied considerably, showing the range in outcome for this challenging patient group. Co-existent PFV in these young patients was common. The incidence of secondary glaucoma was similar to other studies, despite the young age at surgery, high percentage of PFV and number of surgical procedures for VAO.


Asunto(s)
Extracción de Catarata , Catarata , Glaucoma , Lentes Intraoculares , Catarata/diagnóstico , Extracción de Catarata/métodos , Estudios de Seguimiento , Humanos , Lactante , Implantación de Lentes Intraoculares/métodos , Complicaciones Posoperatorias/epidemiología , Estudios Prospectivos , Estudios Retrospectivos
20.
Acta Ophthalmol ; 100(6): 648-653, 2022 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-34890490

RESUMEN

PURPOSE: The main objective of this study was to examine the pupillary response in patients with Marfan syndrome (MFS) and secondarily to determine whether changes in the pupillary response are associated with the increased disability glare previously shown in the same patient population. METHODS: This study included 60 eyes of 34 patients with MFS diagnosed in accordance with the Ghent-2 criteria and 81 eyes of 44 controls. Pupillary response was measured with a pupillograph and disability glare with a straylight meter. RESULTS: The patients with MFS had a significantly smaller maximum pupil size than the control group, 4.87 (4.50-5.23) mm versus 5.58 (5.25-5.90) mm (p = 0.01). In addition, they exhibited slower contraction velocities (p = 0.03) and longer re-dilation times (p = 0.01) compared with the control group. The mean straylight value was higher in patients with MFS than controls, even when including pupillary parameters together with lens surgery, cataract, iris colour, axial length and corneal curvature as possible explanatory variables in the analysis. However, when including data from both groups, a significant negative correlation was seen between maximum pupillary diameter and straylight value (p = 0.01). The other pupillary parameters did not correlate with straylight. CONCLUSION: Patients with MFS had a smaller maximum pupil diameter, slower pupillary contraction and longer re-dilation time than the controls. Despite the correlation between pupil size and straylight value, the pupillary response demonstrated in MFS eyes could not explain the increased straylight in these patients.


Asunto(s)
Síndrome de Marfan , Adulto , Deslumbramiento , Humanos , Luz , Síndrome de Marfan/complicaciones , Síndrome de Marfan/diagnóstico , Pupila/fisiología , Dispersión de Radiación
SELECCIÓN DE REFERENCIAS
DETALLE DE LA BÚSQUEDA