| 1. |
- Claesson, Margareta, 1951, et al.
(författare)
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Astigmatism and the Impact of Relaxing Incisions After Penetrating Keratoplasty
- 2006
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Ingår i: Journal of Refractive Surgery. - 1081-597X. ; 23:3, s. 284-9
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Tidskriftsartikel (refereegranskat)abstract
- Astigmatism and the impact of relaxing incisions after penetrating keratoplasty.Claesson M, Armitage WJ. Department of Ophthalmology, Sahlgrenska University Hospital, Mölndal, Sweden. margareta.l.claesson@vgregion.se PURPOSE: To determine the impact of relaxing incisions for correcting postoperative astigmatism following penetrating keratoplasty. METHODS: Data were collected through the Swedish Corneal Transplant Register. Of the 1161 grafts with complete 2-year follow-up, 131 underwent relaxing incisions. Stepwise multiple regression was used to determine the factors that influenced the extent of astigmatism in diopters (D) (square root transformed). The change in astigmatism brought about by relaxing incisions was evaluated both by subtraction (ie, ignoring angle) and vector analysis. RESULTS: The overall mean astigmatism was 4.56 D (95% confidence interval [CI]: 4.40-4.73, n = 1161). The final regression model explained only a small proportion of the overall variability of the data (< 5%). There was a slight increase in postoperative astigmatism with recipient age (P = .025), and two of the seven participating clinics achieved lower levels of astigmatism (P = .001 and P = .036, respectively). In patients who underwent relaxing incisions, astigmatism was reduced from 8.40 D (95% CI: 8.0-9.0, n = 131) to 3.80 D (95% CI: 3.5-4.3). The mean difference by subtraction was 4.50 D (95% CI: 4.0-5.0, P < .001, paired t test). Vector analysis showed the overall reduction of astigmatism due to surgery to be 7.90 D (95% CI: 7.2-8.7). Compared with grafts with no refractive surgery, a trend was noted that suggested corrected visual acuity was improved following relaxing incisions. CONCLUSIONS: Relaxing incisions were found to be a safe and effective method for reducing postoperative astigmatism and may improve visual acuity. PMID: 17385295 [PubMed - indexed for MEDLINE]
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| 2. |
- Claesson, Margareta, 1951, et al.
(författare)
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Corneal oedema after cataract surgery: predisposing factors and corneal graft outcome.
- 2009
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Ingår i: Acta ophthalmologica. - : Wiley. - 1755-3768 .- 1755-375X. ; 87:2, s. 154-9
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: Pseudophakic bullous keratopathy (PBK) is one of the main indications for corneal transplantation. Graft survival and visual outcome in this group are often poorer than for other indications. The aim of this study was to find risk factors for developing corneal oedema after cataract surgery and factors that influence the subsequent survival of the graft and the visual outcome. METHODS: We carried out an observational, retrospective cohort study using data from the Swedish Cornea Transplant Register and patient medical records. A total of 273 patients whose indication for corneal transplantation was corneal oedema after cataract surgery were included in the study. Multiple logistic regression analysis and, where appropriate, univariate analyses were applied. RESULTS: A total of 43% of the patients developed persistent corneal oedema immediately after cataract surgery, the main risk factors for which were phacoemulsification and pre-existing endothelial disease. Almost a third (32%) of the transplants for PBK failed within 2 years, for which rejection and other postoperative complications increased the risk. Half (50%) the patients had visual acuity < or = 0.1 at 2 years after keratoplasty. Comorbidity, increasing duration of the bullous keratopathy and increasing age affected the visual outcome negatively. CONCLUSIONS: Phacoemulsification was a risk factor for immediate persistent corneal oedema after cataract surgery, although it did not increase the overall risk of developing PBK. However, transplants for immediate PBK had a better survival rate than those for later onset PBK. Shorter duration of PBK and intraocular lens exchange at the time of penetrating keratoplasty increased the likelihood of good visual acuity.
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| 3. |
- Claesson, Margareta, 1951
(författare)
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Corneal transplant outcome- a Swedish register
- 2008
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Aim. The aim of this study was to present different aspects of the outcome after corneal transplantation based on data from the Swedish Cornea Register. Papers. The first paper describes the register and gives descriptive statistics and analysis of data from a two-year follow up, while the last paper presents data from a ten-year follow up. Papers two and three deal with two specific problems in corneal transplantation, astigmatism and corneal oedema after cataract surgery (bullous keratopathy, BK). Paper four and five compare the Swedish patients with a cohort from the Middle East. Results. The major indications were keratoconus (29%), BK (21%) and a mixed group of other diagnoses (32%), including regraft. The overall incidence of rejection at two years was 15%, and regrafting, which occurred in 10% of cases was related to rejection and other complications. Visual acuity (VA) after two years improved most in keratoconus and this was still the case after ten years. Most changes in visual outcome after PK in all indications occurred during the first two postoperative years. Graft survival and VA at ten years depended mainly on complications occurring before two years postoperative. The mean value of astigmatism at two years was 4.6 D (95% CI 4.4-4.7), independent of indication and preoperative astigmatism. In a group with high astigmatism (mean value 8.4 D) relaxing incisions reduced the astigmatism by 50%. At ten years there was a small increase in astigmatism in all indications. Bullous keratopathy was one of the indications with poorest outcome. The risk of developing BK at the time of cataract surgery was influenced by pre-existing endothelial disease and cataract surgery done by phaco-emulsification. In the Palestinian Territories the preponderance of keratoconus was higher than in Sweden. The patients came to surgery with a more advanced disease and more risk factors. They also developed more postoperative complication and the outcome was poorer, even though most gained some visual acuity. Conclusion. Through the data analysed from the register our knowledge of the outcome after corneal transplantation has increased. The register will also allow evaluation of new techniques of corneal transplantation.
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| 4. |
- Hardarson, Thorir, 1967, et al.
(författare)
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Time-lapse recordings of human corneal epithelial healing
- 2004
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Ingår i: Acta Ophthalmologica Scandinavica. - 1395-3907. ; 82, s. 184-8
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Tidskriftsartikel (refereegranskat)abstract
- Time-lapse recordings of human corneal epithelial healing.Hardarson T, Hanson C, Claesson M, Stenevi U. Department of Obstetrics and Gynaecology, Gothenburg University, Gothenburg, Sweden. PURPOSE: The aim of this study was to design an experimental set-up for the study of human corneal epithelial wound healing in a controlled in vitro situation. METHODS: A time-lapse set-up was used. This allowed for pictures to be captured with a magnification ranging from x 80 to x 1800. Pictures were captured at 1-min intervals during the observation period, which lasted up to 4 days. Human corneal tissue was obtained from the Eye Bank or from surgery. A small, rounded lesion was produced in the corneal epithelium with a miniature drill. The specimens were placed in a mini-incubator; the camera focused on the epithelial lesion and continuously observed using the time-lapse set-up. RESULTS: The healing process of human corneal epithelium could be followed for several days. The initial healing response could be divided into a slow, a rapid and a consolidating phase. The first two phases lasted about 12 hours, and by then, epithelial cells covered the lesion. Depending on the origin of the tissue and the placement of the lesion, variations in the healing response could be seen. CONCLUSION: The time-lapse technique makes it possible to study epithelial wound healing over time at the cellular level. Data collected in this way can fill the gap between in vivo studies, where, by nature, human wound healing studies are restricted, and cell culture techniques, where cellular responses in many cases differ from the in vivo situation. PMID: 15043538 [PubMed - indexed for MEDLINE]
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| 5. |
- Lagali, Neil, et al.
(författare)
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Donor and recipient endothelial cell population of the transplanted human cornea: a two-dimensional imaging study.
- 2010
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Ingår i: Investigative ophthalmology & visual science. - : Association for Research in Vision and Ophthalmology (ARVO). - 1552-5783 .- 0146-0404. ; 51:4, s. 1898-904
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Tidskriftsartikel (refereegranskat)abstract
- Purpose. To elucidate the pattern of donor and recipient endothelial cell populations in transplanted human corneas and determine the degree to which donor endothelial cells survive in the graft. Methods. Thirty-six corneal grafts were collected from recipients of opposite sex to the donor, at the time of retransplantation for various indications. Cells from the endothelial side of the grafts were harvested, preserving their relative location on the endothelium. Fluorescence in situ hybridization of the sex chromosomes enabled each cell to be identified as donor- or recipient-derived. Images of the graft endothelium were assembled, to depict the pattern of cell population of the graft, and the proportion of donor cells present was estimated. Results. Endothelial cells of donor origin were found in 26 of 36 grafts (72.2%)-in one case, up to 26 years after transplantation. The proportion of donor endothelium ranged from 2% to 99%; however, there was no significant correlation of this proportion with postoperative time (P = 0.19). The mean annual rate of donor cell loss correlated negatively with the time to graft failure by endothelial decompensation (P = 0.002). Endothelial images indicated a highly variable pattern of recipient cell repopulation of the graft. A tendency toward donor cell retention in transparent, successful grafts was noted; however, this feature alone was not a reliable indicator of long-term graft transparency. Conclusions. Two-dimensional imaging of the corneal graft endothelium revealed a variable pattern and extent of donor and recipient cell population, indicating the highly dynamic nature of the corneal endothelium after transplantation.
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| 6. |
- Lagali, Neil, et al.
(författare)
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Survival of donor-derived cells in human corneal transplants.
- 2009
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Ingår i: Investigative ophthalmology & visual science. - : Association for Research in Vision and Ophthalmology (ARVO). - 1552-5783. ; 50:6, s. 2673-8
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: To determine the fate of donor epithelial, stromal, and endothelial cells after corneal transplantation in humans. METHODS: Fifty-two transplanted corneal buttons were explanted over a 2-year period from patients who required regrafting and had received corneas from donors of opposite sex. Fluorescence in situ hybridization of the sex chromosomes of the epithelial, stromal, and endothelial cells was performed in histologic sections prepared from each freshly explanted graft. Fluorescence microscopy was subsequently used to determine the origin of cells in the graft (donor or recipient) and to quantify the relative proportion of donor and recipient cells of each corneal cell type. RESULTS: As early as 3 months after transplantation, donor epithelial cells were completely replaced by recipient epithelium in all corneal buttons examined. Donor stromal and endothelial cells, however, were found in all 52 buttons, with 4% to 95% of stromal cells and 6% to 95% of endothelial cells being of donor origin. No significant correlation between donor cell proportion and the age of the graft could be found. Donor-derived cells were found in significant numbers up to 32 years after transplantation. Eight corneas in this study were transparent, compensated grafts, and a similar long-term survival of donor stromal and endothelial cells was found in these cases. CONCLUSIONS: Although donor epithelial cells are promptly replaced, a high proportion of donor stromal and endothelial cells can survive within the corneal transplant in the long-term. The proportion of surviving donor cells is highly variable; however, the source of this variability remains unknown.
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| 7. |
- Wonneberger, Wolf, 1976, et al.
(författare)
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Genetic variants in the FOXO1 and ZNF469 genes are associated with keratoconus in Sweden: a case-control study
- 2024
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Ingår i: BMC OPHTHALMOLOGY. - 1471-2415. ; 24:1
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Tidskriftsartikel (refereegranskat)abstract
- Background Keratoconus (KC) is characterized by pathological thinning and bulging of the cornea that may lead to visual impairment. The etiology of sporadic KC remains enigmatic despite intensive research in recent decades. The purpose of this study was to examine the relationship between previously highlighted genetic variants associated with KC and sporadic KC in a Swedish cohort. Methods A total of 176 patients (age 16-70 years) with sporadic KC diagnosed by Scheimpflug-topography (Pentacam) were included. The control group (n = 418; age 70 years) was a subsample originating from the Gothenburg H70 Birth Cohort Studies of ageing. Extraction of DNA from blood samples was performed according to standard procedures, and genotyping was performed using competitive allele specific PCR (KASP) technology. A total of 11 single nucleotide polymorphisms (SNPs) were selected for analysis. Results Statistically significant associations (p = 0.005) were found between the SNPs rs2721051 and rs9938149 and sporadic KC. These results replicate earlier research that found associations between genetic variants in the FOXO1 and BANP-ZNF469 genes and sporadic KC in other populations. ConclusionGenetic variations in the FOXO1 and BANP-ZNF469 genes may be involved in the pathogenesis of sporadic KC.
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| 8. |
- Wonneberger, Wolf, 1976, et al.
(författare)
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Repeated Same-Day Versus Single Tomography Measurements of Keratoconic Eyes for Analysis of Disease Progression.
- 2018
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Ingår i: Cornea. - 1536-4798. ; 37:4, s. 474-479
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Tidskriftsartikel (refereegranskat)abstract
- Corneal tomography is used to assess progression of keratoconus and to direct clinical decisions regarding corneal cross-linking. The purpose of this study was to analyze the variability of repeated Scheimpflug-tomography (Pentacam Classic; Oculus, Wetzlar, Germany) measurements of keratoconic eyes in a clinical setting and to assess the validity of such measurements as a clinical decision-making tool.Eighty keratoconic eyes of 45 patients (age range 16-32 years) were examined at baseline and after follow-up periods of 3 to 6 months using 3 consecutive tomography measurements at each visit. Minimum corneal thickness and anterior sagittal curvature map parameters were studied [simulated keratometry (K) astigmatism (SimKast); maximum simulated K-reading (SimKmax); average SimK (SimKave); maximum K-readings on the 3-mm (Kmax3) and 5-mm (Kmax5) rings; and maximum K-reading (Kmax)].When comparing the first measurements at the first and second visits, respectively, 9% to 20% of eyes were classified as progressive depending on which parameter was chosen. Using the average of 3 consecutive measurements at each visit, 5% to 19% of eyes were classified as progressive. An increase in the SD of 3 consecutive measurements of SimKast (SD_SimKast) at the first visit of 1 diopter makes true progression of keratoconus 3.6 times more likely (odds ratio = 3.6; 95% confidence interval: 0.846-16.027; area under the curve = 0.70).The approach used to analyze progression in keratoconus, that is, single versus repeated measurements, may confer a great impact on the decision to perform corneal cross-linking treatment or not.
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