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  • 51.
    Johansson, Björn
    et al.
    Linköpings universitet, Institutionen för nervsystem och rörelseorgan. Linköpings universitet, Institutionen för klinisk och experimentell medicin, Oftalmologi. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Rekonstruktionscentrum, Ögonkliniken US/LiM.
    Jakobsson, Peter
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Oftalmologi. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Rekonstruktionscentrum, Ögonkliniken US/LiM.
    Luminance and color contrast sensitivity and VEP latency in subjects with normal and defective binocularity1997Ingår i: European Journal of Ophthalmology, ISSN 1724-6016, Vol. 7, s. 82-90Artikel i tidskrift (Refereegranskat)
  • 52.
    Johansson, Björn
    et al.
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för klinisk och experimentell medicin, Oftalmologi. Östergötlands Läns Landsting, Rekonstruktionscentrum, Ögonkliniken US/LiM.
    Lundh, Björn
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för klinisk och experimentell medicin, Oftalmologi. Östergötlands Läns Landsting, Rekonstruktionscentrum, Ögonkliniken US/LiM.
    Bilateral same day phacoemulsification: 220 Cases retrospectively reviewed2003Ingår i: British Journal of Ophthalmology, ISSN 0007-1161, E-ISSN 1468-2079, Vol. 87, nr 3, s. 285-290Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background/aims: The relative frequency, basic patient data, results, and complications of planned same day bilateral phacoemulsification were studied from April 1999 to May 2001 at the Department of Ophthalmology, Linköping University Hospital, Sweden. Methods: Retrospective study of patient records (n=220) regarding preoperative and postoperative visual acuity, applied indications, concurrent disease, preoperative, peroperative, and postoperative complications, and number of unplanned postoperative visits. The monthly rate of bilateral phacoemulsification to all cataract procedures was monitored. Results: Mean corrected preoperative visual acuity was 0.27 (worse eye) and 0.39 (better eye), and postoperatively (all eyes) 0.71. Visual acuity was 0.5 or better in 78% of eyes. Preoperative considerations included type of cataract, to avoid anisometropia, social circumstances, and concurrent eye disease. Reasons for unplanned postoperative visits included secondary cataract (n=10), iritis (n=6), corneal oedema (n=3), cortex in the anterior chamber (n=2), and unilateral endophthalmitis (n=2). During the study period, 10.5% of patients were operated upon bilaterally on the same day. Conclusions: Same day bilateral phacoemulsification was found to be a safe and cost effective way of rapidly rehabilitating selected cataract patients. The patient must be informed of the added potential risks as well as the benefits of the procedure.

  • 53.
    Johansson, Björn
    et al.
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för klinisk och experimentell medicin, Oftalmiatrik. Östergötlands Läns Landsting, Rekonstruktionscentrum, Ögonkliniken US/LiM.
    Sundelin, Staffan
    Institute of Clinical Neuroscience, Göteborg University, Göteborg.
    Wikberg-Matsson, Anna
    Section of Ophthalmology, Göteborg University, Göteborg.
    Unsbo, Peter
    Department of Applied Physics, Stockholm.
    Behndig, Anders
    Department of Clinical Science/Ophthalmology, Umeå University Hospital, Umeå, Sweden.
    Visual and optical performance of the Akreos Adapt Advanced Optics and Tecnis Z9000 intraocular lenses: Swedish multicenter study2007Ingår i: Journal of cataract and refractive surgery, ISSN 0886-3350, E-ISSN 1873-4502, Vol. 33, nr 9, s. 1565-1572Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Purpose

    To compare the subjective visual and objective optical performance of 2 aspherical intraocular lenses (IOLs), the Akreos Adapt Advanced Optics (AO) (Bausch & Lomb, Inc.) and the Tecnis Z9000 (Advanced Medical Optics, Inc.).

    Setting

    Four university hospitals in Sweden.

    Methods

    This study comprised 80 patients, 20 each from 4 university hospital centers in Sweden. All patients had bilateral clear corneal phacoemulsification with implantation of an Akreos Adapt AO IOL in 1 eye and Tecnis Z9000 IOL in the other eye according to a randomization protocol. Preoperatively, 90% contrast Early Treatment Diabetic Retinopathy Study (ETDRS) visual acuity was measured and the mesopic pupil sizes were determined. Ten to 12 weeks postoperatively, 12.5% and 90% contrast ETDRS visual acuities and photopic and mesopic Functional Acuity Contrast Test chart contrast sensitivities were determined. Wavefront analysis was performed with the Zywave II aberrometer (Bausch & Lomb, Inc.), and a questionnaire on the subjective quality of vision was completed by each patient.

    Results

    The Akreos AO IOL and Tecnis Z9000 IOL produced similar high- and low-contrast visual acuities as well as photopic and mesopic contrast sensitivities. The Tecnis Z9000 IOL resulted in lower spherical aberrations of the eye (mean 0.05 ± 0.13 μm versus 0.35 ± 0.13 μm root mean square, 6.0 mm pupil) (P<.001); however, the Akreos AO IOL provided a larger depth of field (mean 1.22 diopter [D] ± 0.48 [SD] versus 0.86 ± 0.50 D, 6.0 mm pupil) (P<.001). Patient satisfaction was generally high, although 68.8% of the patients reported some type of visual disturbance postoperatively. Twenty-eight percent of patients reported better subjective visual quality in the Akreos AO eye and 14%, in the Tecnis Z9000 eye (P<.0001). Accordingly, 33% perceived more visual disturbances in the Tecnis Z9000 eye and 11%, in the Akreos AO eye (P<.0001).

    Conclusions

    Maximum reduction of spherical aberration did not maximize subjective visual quality. The higher perceived quality of vision with the Akreos AO IOL could be because of differences in depth of field, IOL material, or IOL design.

  • 54.
    Koulikovska, Marina
    et al.
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för klinisk och experimentell medicin, Oftalmologi. Östergötlands Läns Landsting, Rekonstruktionscentrum, Ögonkliniken US/LiM.
    Podskochy, Alexander
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för klinisk och experimentell medicin, Oftalmologi. Östergötlands Läns Landsting, Rekonstruktionscentrum, Ögonkliniken US/LiM.
    Fagerholm, Per
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för klinisk och experimentell medicin, Oftalmologi. Östergötlands Läns Landsting, Rekonstruktionscentrum, Ögonkliniken US/LiM.
    Expression of the chaperonin containing T-complex polypeptide 1 chaperonin subunit during corneal wound healing2003Ingår i: Investigative Ophthalmology and Visual Science, ISSN 0146-0404, E-ISSN 1552-5783, Vol. 44, s. 854-Konferensbidrag (Övrigt vetenskapligt)
  • 55. Kullberg, C
    et al.
    Abrahamsson, M
    Arnqvist, Hans
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för biomedicin och kirurgi, Cellbiologi. Östergötlands Läns Landsting, MKC - Medicin och kirurgicentrum, EMK-endokrin.
    Finnström, Kerstin
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för nervsystem och rörelseorgan, Oftalmologi. Östergötlands Läns Landsting, Rekonstruktionscentrum, Ögonkliniken US/LiM.
    Ludvigsson, Johnny
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för molekylär och klinisk medicin, Pediatrik. Östergötlands Läns Landsting, Barn- och kvinnocentrum, Barn.
    Prevalence of retinopathy differs with age at onset of diabetes in a population of patients with Type 1 diabetes2002Ingår i: Diabetic Medicine, ISSN 0742-3071, E-ISSN 1464-5491, Vol. 19, nr 11, s. 924-931Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Aim. The VISS study (Vascular complications in South-east Sweden) investigates prevalence and incidence of vascular complications in a population with Type 1 diabetes, from a well-defined geographical area and followed from diag-nosis with HbA1c measurement. Method. The study population comprised all 440 patients with Type 1 diabetes onset before the age of 36 years, onset during 1983-1987, and at the time of onset living within the counties of J÷nk÷ping, Kalmar or ╓sterg÷tland. Retinopathy was examined with fundus photography 1994-1995, and classified according to a modified Airlie House protocol. Results. Fundus photographs from 390 patients were evaluated. In 277 (71%) patients no retinopathy was seen. The prevalence of retinopathy increased from 11% among patients < 5 years old at diabetes onset, to 48% among those 15-19 years old at diabetes onset, and then decreased to 30% for patients 30-35 years old at diabetes onset (P for ?2 for linear trend for all ages 0.017, for age at onset 0-19 yearsP = 0.0003), without corresponding differences in duration or HbA1c between patients with different onset age. Patients with HbA1c in the highest quartile (> 8.3% HbA1c) had a relative risk of 2.4 (95% confidence) interval (CI) 1.7-3.2) of having any retinopathy compared with patients with lower HbA1c, and a relative risk of 7.1 (95% CI 3.0-16.7) of having other forms of retinopathy than microaneurysms. Conclusion. In patients with diabetes duration of 6-13 years, the prevalence of retinopathy is clearly related to glycaemic control. Furthermore, the risk of retinopathy varies with different age at onset, independently of differences in duration or glycaemic control.

  • 56.
    Kurz, Tino
    et al.
    Linköpings universitet, Institutionen för medicin och hälsa, Farmakologi. Linköpings universitet, Hälsouniversitetet.
    Karlsson, Markus
    Linköpings universitet, Institutionen för klinisk och experimentell medicin. Linköpings universitet, Hälsouniversitetet.
    Brunk, Ulf
    Linköpings universitet, Institutionen för medicin och hälsa, Farmakologi. Linköpings universitet, Hälsouniversitetet.
    Erik Nilsson, Sven
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Oftalmiatrik. Linköpings universitet, Hälsouniversitetet.
    Frennesson, Christina
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Oftalmiatrik. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Rekonstruktionscentrum, Ögonkliniken US/LiM.
    ARPE-19 retinal pigment epithelial cells are highly resistant to oxidative stress and exercise strict control over their lysosomal redox-active iron2009Ingår i: AUTOPHAGY, ISSN 1554-8627, Vol. 5, nr 4, s. 494-501Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Normal retinal pigment epithelial (RPE) cells are postmitotic, long-lived and basically not replaced. Daily, they phagocytose substantial amounts of lipid-rich material (photoreceptor outer segment discs), and they do so in the most oxygenated part of the body-the retina. One would imagine that this state of affairs should be associated with a rapid formation of the age pigment lipofuscin (LF). However, LF accumulation is slow and reaches significant amounts only late in life when, if substantial, it often coincides with or causes age-related macular degeneration. LF formation occurs inside the lysosomal compartment as a result of iron-catalyzed peroxidation and polymerization. This process requires phagocytosed or autophagocytosed material under degradation, but also the presence of redox-active low mass iron and hydrogen peroxide. To gain some information on how RPE cells are able to evade LF formation, we investigated the response of immortalized human RPE cells (ARPE-19) to oxidative stress with/without the protection of a strong iron-chelator. The cells were found to be extremely resistant to hydrogen peroxide-induced lysosomal rupture and ensuing cell death. This marked resistance to oxidative stress was not explained by enhanced degradation of hydrogen peroxide, but to a certain extent further increased by the potent lipophilic iron chelator STH. The cells were also able to survive, and even replicate, at high concentrations of SIH and showed a high degree of basal autophagic flux. We hypothesize that RPE cells have a highly developed capacity to keep lysosomal iron in a nonredox-active form, perhaps by pronounced autophagy of iron-binding proteins in combination with an ability to rapidly relocate low mass iron from the lysosomal compartment.

  • 57.
    Lagali, Neil
    et al.
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Oftalmiatrik. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Rekonstruktionscentrum, Ögonkliniken US/LiM.
    Dellby, Anette
    Östergötlands Läns Landsting.
    Fagerholm, Per
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Oftalmiatrik. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Rekonstruktionscentrum, Ögonkliniken US/LiM.
    In vivo confocal microscopy of the cornea in Darier-White disease.2009Ingår i: Archives of ophthalmology, ISSN 1538-3601, Vol. 127, nr 6, s. 816-818Artikel i tidskrift (Övrigt vetenskapligt)
    Abstract [en]

    n/a

  • 58.
    Lagali, Neil
    et al.
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Oftalmiatrik. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Rekonstruktionscentrum, Ögonkliniken US/LiM.
    Fagerholm, Per
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Oftalmiatrik. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Rekonstruktionscentrum, Ögonkliniken US.
    Corneal injury by formic acid: one-year clinical course and in-vivo confocal microscopic evaluation2008Ingår i: Clinical and Experimental Ophthalmology, ISSN 1442-6404, E-ISSN 1442-9071, Vol. 36, nr 7, s. 692-694Artikel i tidskrift (Övrigt vetenskapligt)
  • 59.
    Lagali, Neil
    et al.
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Oftalmologi. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Rekonstruktionscentrum, Ögonkliniken US/LiM.
    Fagerholm, Per
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Oftalmologi. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Rekonstruktionscentrum, Ögonkliniken US/LiM.
    Delayed Mustard Gas Keratitis: Clinical Course and In Vivo Confocal Microscopy Findings2009Ingår i: CORNEA, ISSN 0277-3740, Vol. 28, nr 4, s. 458-462Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Purpose: To report the detailed clinical and in vivo confocal microscopic findings in a patient with delayed-onset mustard gas keratitis observed 20 years after initial exposure.

    Methods: A 38-year-old man who was exposed to mustard gas in Iraq at the age of 19 years was examined after presenting with ocular symptoms 17 years after initial recovery from the exposure. Slit-lamp biomicroscopy, corneal topography, and in vivo confocal microscopy were performed on both corneas.

    Results: The clinical symptoms were consistent with a delayed form of mustard gas keratitis, although the patient had clear central corneas and good visual acuity. Confocal microscopic findings included evidence of epithelial abnormalities, necrotic changes in the anterior stroma, subbasal and anterior stromal nerve proliferation, and deep stromal keratocyte activation.

    Conclusions: In vivo confocal microscopy revealed persistent morphologic abnormalities in the anterior stroma of both corneas 20 years after initial exposure to mustard gas. The detection of a population of dendritic cell bodies in the central epithelium and evidence of keratocyte activation and migration in the deep stroma indicated the presence of ongoing subclinical processes.

  • 60.
    Lagali, Neil
    et al.
    Östergötlands Läns Landsting, Rekonstruktionscentrum, Ögonkliniken US/LiM. Linköpings universitet, Institutionen för klinisk och experimentell medicin, Oftalmiatrik. Linköpings universitet, Hälsouniversitetet.
    Fagerholm, Per
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Oftalmiatrik. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Rekonstruktionscentrum, Ögonkliniken US/LiM.
    Letter: A case of chronic ocular irritation associated with progressive corneal opacification2009Ingår i: Acta Ophthalmologica, ISSN 1755-375X, E-ISSN 1755-3768, Vol. 87, nr 8, s. 932-934Artikel i tidskrift (Övrigt vetenskapligt)
    Abstract [en]

    n/a

  • 61.
    Lagali, Neil
    et al.
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Oftalmiatrik. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Sinnescentrum.
    Fagerholm, Per
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Oftalmiatrik. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Rekonstruktionscentrum, Ögonkliniken US/LiM.
    Griffith, May
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Oftalmiatrik. Linköpings universitet, Hälsouniversitetet.
    Editorial Material: Biosynthetic corneas: prospects for supplementing the human donor cornea supply in EXPERT REVIEW OF MEDICAL DEVICES, vol 8, issue 2, pp 127-1302011Ingår i: Expert Review of Medical Devices, ISSN 1743-4440, E-ISSN 1745-2422, Vol. 8, nr 2, s. 127-130Artikel i tidskrift (Övrigt vetenskapligt)
    Abstract [en]

    n/a

  • 62.
    Lagali, Neil
    et al.
    Östergötlands Läns Landsting, Rekonstruktionscentrum, Ögonkliniken US/LiM. Linköpings universitet, Institutionen för klinisk och experimentell medicin, Oftalmologi. Linköpings universitet, Hälsouniversitetet.
    Germundsson, Johan
    Linköpings universitet, Institutionen för klinisk och experimentell medicin. Linköpings universitet, Hälsouniversitetet.
    Fagerholm, Per
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Oftalmologi. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Rekonstruktionscentrum, Ögonkliniken US/LiM.
    The Role of Bowmans Layer in Corneal Regeneration after Phototherapeutic Keratectomy: A Prospective Study Using In Vivo Confocal Microscopy2009Ingår i: INVESTIGATIVE OPHTHALMOLOGY and VISUAL SCIENCE, ISSN 0146-0404, Vol. 50, nr 9, s. 4192-4198Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    PURPOSE. To examine the role of Bowmans layer (BL) on the nature of anterior corneal regeneration after excimer laser phototherapeutic keratectomy (PTK). METHODS. A cohort of 13 patients underwent PTK to remove either 7 mu m of BL for treatment of primary recurrent corneal erosions (RCE; six patients) or complete BL removal (15-mu m ablation) to treat RCE or poor vision secondary to map-dot-fingerprint (MDF) dystrophy (seven patients). Clinical examinations and laser-scanning in vivo confocal microscopy (IVCM) were conducted before surgery and at a mean of 4 and 8 months after surgery. RESULTS. Total BL removal resulted in a significant decline in subbasal nerve density at 4 months (P = 0.007) that barely recovered to preoperative levels at 8 months (P = 0.055). With BL partially present, subbasal nerve density did not significantly change from preoperative levels. Superficial, wing, and basal epithelial cell density recovered to preoperative levels within 4 months after PTK, regardless of the presence of BL. Subepithelial keratocytes, however, were more densely distributed in corneas without BL relative to those with a partial BL present (P = 0.005), and increased anterior keratocyte reflectivity was noted in all eyes without BL and in no eye with a partial BL present. CONCLUSIONS. Subbasal nerve regeneration is delayed and subepithelial keratocyte density and reflectivity remain elevated up to 10 months after total BL removal by PTK. The results provide initial evidence for a possible role of BL in facilitating rapid stromal wound healing and an associated recovery of anterior corneal transparency and the restoration of epithelial innervation after epithelial trauma.

  • 63.
    Lagali, Neil
    et al.
    University of Ottawa Eye Institute.
    Griffith, May
    Univ Ottawa, Dept Cellular & Mol Med, Ottawa, ON, Canada.
    Fagerholm, Per
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för klinisk och experimentell medicin, Oftalmologi. Östergötlands Läns Landsting, Rekonstruktionscentrum, Ögonkliniken US/LiM.
    Merrett, Kimberley
    University of Ottawa Eye Institute.
    Huynh, Melissa
    University of Ottawa Eye Institute.
    Munger, Rejean
    University of Ottawa Eye Institute.
    Innervation of tissue-engineered recombinant human collagen-based corneal substitutes: A comparative in vivo confocal microscopy study2008Ingår i: Investigative Ophthalmology and Visual Science, ISSN 0146-0404, E-ISSN 1552-5783, Vol. 49, nr 9, s. 3895-3902Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    PURPOSE. To compare reinnervation in recombinant human collagen-based corneal substitutes with allografts during a 1-year postimplantation follow-up period in pigs. A retrospective comparison to innervation in porcine collagen-based biosynthetic grafts was also performed. METHODS. Pigs received a corneal allograft or a substitute made of either recombinant human type-I or -III collagen. In vivo confocal microscopic examination of the central cornea of surgical and untouched control eyes before surgery and at 2, 6, and 12 months after surgery was performed to quantify the number, density, and diameter of nerves at various corneal depths. RESULTS. By 12 months after surgery, the number and density of regenerated nerves in the anterior and deep anterior corneal stroma recovered to preoperative and control levels in both types of substitute grafts and in the allografts. In the subepithelial and subbasal regions, however, significantly fewer nerves were detected relative to those in control subjects at 12 months, regardless of graft type ( P < 0.05), similar to the behavior of porcine collagen-based biosynthetic grafts. An absence of thick stromal nerve trunks (diameter, > 10 mu m) in all grafts, irrespective of material type, indicated that nerve regeneration in grafts was accompanied by persistent morphologic changes. CONCLUSIONS. Nerve regeneration in recombinant human collagen-based biosynthetic corneal grafts proceeded similarly to that in allograft tissue, demonstrating the suitability of recombinant human collagen constructs as nerve-friendly corneal substitutes. Furthermore, only minor differences were noted between type-I and -III collagen grafts, indicating an insensitivity of nerve regeneration to initial collagen type.

  • 64.
    Lagali, Neil
    et al.
    Östergötlands Läns Landsting, Rekonstruktionscentrum, Ögonkliniken US/LiM. Linköpings universitet, Institutionen för klinisk och experimentell medicin, Oftalmologi. Linköpings universitet, Hälsouniversitetet.
    Stenevi, U.
    Östergötlands Läns Landsting, Rekonstruktionscentrum, Ögonkliniken US/LiM.
    Claesson, M.
    Östergötlands Läns Landsting, Rekonstruktionscentrum, Ögonkliniken US/LiM.
    Fagerholm, Per
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Oftalmologi. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Rekonstruktionscentrum, Ögonkliniken US/LiM.
    Hanson, C.
    Östergötlands Läns Landsting, Rekonstruktionscentrum, Ögonkliniken US/LiM.
    Weijdegard, B.
    Östergötlands Läns Landsting, Rekonstruktionscentrum, Ögonkliniken US/LiM.
    Survival of donor-derived cells in human corneal transplants.2009Ingår i: Investigative ophthalmology and visual science, ISSN 1552-5783, Vol. 50, nr 6, s. 2673-2678Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    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.

  • 65.
    Lagali, Neil
    et al.
    Östergötlands Läns Landsting, Rekonstruktionscentrum, Ögonkliniken US/LiM. Linköpings universitet, Institutionen för klinisk och experimentell medicin, Oftalmologi. Linköpings universitet, Hälsouniversitetet.
    Stenevi, Ulf
    Sahlgrens University Hospital.
    Claesson, Margareta
    Sahlgrens University Hospital.
    Fagerholm, Per
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Oftalmologi. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Rekonstruktionscentrum, Ögonkliniken US/LiM.
    Hanson, Charles
    Gothenburg University.
    Weijdegard, Birgitta
    Gothenburg University.
    Strombeck, Anne-Sophie
    University Uppsala Hospital.
    Donor and Recipient Endothelial Cell Population of the Transplanted Human Cornea: A Two-Dimensional Imaging Study2010Ingår i: INVESTIGATIVE OPHTHALMOLOGY and VISUAL SCIENCE, ISSN 0146-0404, Vol. 51, nr 4, s. 1898-1904Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    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.

  • 66.
    Lagali, Neil
    et al.
    Östergötlands Läns Landsting, Rekonstruktionscentrum, Ögonkliniken US/LiM.
    Stenevi, Ulf
    Sahlgrens University Hospital.
    Fagerholm, Per
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Oftalmiatrik. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Rekonstruktionscentrum, Ögonkliniken US/LiM.
    Claesson, Margareta
    Sahlgrens University Hospital.
    Letter: Author Response: Donor Cell Survival in Corneal Grafts2010Ingår i: Investigative Ophthalmology and Visual Science, ISSN 0146-0404, E-ISSN 1552-5783, Vol. 51, nr 8, s. 3843-3845Artikel i tidskrift (Övrigt vetenskapligt)
    Abstract [en]

    n/a

  • 67.
    Lagali, N.S.
    et al.
    University of Ottawa Eye Institute, University of Ottawa, Ottawa, ON, Canada.
    Griffith, M.
    University of Ottawa Eye Institute, University of Ottawa, Ottawa, ON, Canada, Department of Cellular and Molecular Medicine, University of Ottawa, Ottawa, ON, Canada.
    Shinozaki, N.
    TDC Eye Bank and Cornea Centre, Ichikawa General Hospital, Chiba, Japan.
    Fagerholm, Per
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för klinisk och experimentell medicin, Oftalmologi. Östergötlands Läns Landsting, Rekonstruktionscentrum, Ögonkliniken US/LiM.
    Munger, R.
    University of Ottawa Eye Institute, University of Ottawa, Ottawa, ON, Canada, University of Ottawa Eye Institute, Ottawa Hospital-General Campus, 501 Smyth Road, Ottawa, ON K1H 8L6, Canada.
    Innervation of tissue-engineered corneal implants in a porcine model: A 1-year in vivo confocal microscopy study2007Ingår i: Investigative Ophthalmology and Visual Science, ISSN 0146-0404, E-ISSN 1552-5783, Vol. 48, nr 8, s. 3537-3544Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    PURPOSE. To examine the pattern of nerve regeneration within tissue-engineered corneal substitutes grafted into host porcine corneas over a 1-year postoperative period. METHODS. Biodegradable corneal substitutes from cross-linked collagen were implanted into the left eyes of 12 pigs by deep lamellar keratoplasty. Regeneration of severed nerves into the central implant region was investigated with in vivo confocal microscopy. Both implant-recipient and control (right) eyes were examined before surgery and 2, 6, 10, and 12 months after surgery, to quantify the number, density, diameter, and branching of nerve fiber bundles at various corneal depths. Transmission electron microscopy was used to confirm the presence of nerve bundles. RESULTS. Two months after surgery, corneal nerve ingrowth was observed within the deep anterior stroma, with a number and density of regenerated nerves significantly higher than in nonsurgical control eyes (P < 0.01). Nerves within the superficial anterior stroma regenerated by 6 to 10 months after surgery, and the first subbasal epithelial nerves were seen 10 months after surgery. After 1 year, subbasal nerve density recovered to preoperative levels. Nerve fibers in the deep anterior stroma remained significantly thinner relative to control eyes after 1 year (P < 0.001), where both superficial anterior and subbasal nerve diameter did not change relative to control eyes. CONCLUSIONS. The pattern of reinnervation within tissue-engineered corneal substitutes has been quantified in vivo. Innervation proceeded rapidly in the deep anterior stroma, followed by repopulation of more superficial regions. One year after surgery, nerve density within the tissue-engineered cornea increased or remained unchanged relative to controls in all corneal regions examined. Copyright © Association for Research in Vision and Ophthalmology.

  • 68.
    Liu, Wenguang
    et al.
    University of Ottawa.
    Deng, Chao
    University of Ottawa.
    McLaughlin, Christopher R
    University of Ottawa.
    Fagerholm, Per
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Oftalmologi. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Rekonstruktionscentrum, Ögonkliniken US/LiM.
    Lagali, Neil S
    University of Ottawa.
    Heyne, Belinda
    University of Ottawa.
    Scaiano, Juan C
    University of Ottawa.
    Watsky, Mitchell A
    University of Tennessee.
    Kato, Yasuhiro
    Tokyo Dental College.
    Munger, Rejean
    University of Ottawa.
    Shinozaki, Naoshi
    Tokyo Dental College.
    Li, Fengfu
    University of Ottawa.
    Griffith, May
    University of Ottawa.
    Collagen-phosphorylcholine interpenetrating network hydrogels as corneal substitutes2009Ingår i: BIOMATERIALS, ISSN 0142-9612, Vol. 30, nr 8, s. 1551-1559Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    A biointeractive collagen-phospholipid corneal Substitute was fabricated from interpenetrating polymeric networks comprising 1-ethyl-3-(3-dimethyl aminopropyl) carbodiimide and N-hydroxysuccinimide crosslinked porcine atelocollagen, and poly(ethylene glycol) diacrylate crosslinked 2-methacryloyloxyethyl phosphorylcholine (MPC). The resulting hydrogels showed ail overall increase in mechanical strength beyond that of either original component and enhanced stability against enzymatic digestion (by collagenase) or UV degradation. More strikingly, these hydrogels retained the full biointeractive, cell friendly properties of collagen in promoting corneal cell and nerve in-growth and, regeneration (despite MPCs known anti-adhesive properties). Measurements of refractive indices, white light transmission and backscatter showed the optical properties of collagen-MPC are comparable or superior to those of the human cornea.In addition, the glucose and albumin permeability were comparable to those Of human corneas. Twelve-month post-implantation results of collagen-MPC hydrogels into mini-pigs showed regeneration of corneal tissue (epithelium, stroma) as well as the tear film and sensory nerves. We also show that porcine collagen can be Substituted with recombinant human collagen, resulting in a fully-synthetic implant that is free from the potential risks of disease transmission (e.g. prions) present in animal Source materials.

  • 69.
    Lundstrom, Mats
    et al.
    Blekinge Hospital.
    Behndig, Anders
    Umeå University Hospital.
    Montan, Per
    St Erik Eye Hospital.
    Artzen, Ditte
    St Erik Eye Hospital.
    Jakobsson, Gunnar
    Sahlgrens University Hospital.
    Johansson, Björn
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Oftalmologi. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Rekonstruktionscentrum, Ögonkliniken US/LiM.
    Thorburn, William
    Umeå University Hospital.
    Stenevi, Ulf
    Sahlgrens University Hospital.
    Capsule complication during cataract surgery: Background, study design, and required additional care Swedish Capsule Rupture Study Group report 12009Ingår i: JOURNAL OF CATARACT AND REFRACTIVE SURGERY, ISSN 0886-3350, Vol. 35, nr 10, s. 1679-1687Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    PURPOSE: To report the selection procedure of complicated and uneventful cataract extractions included in the Swedish Capsule Rupture Study and to describe the additional care required after a capsule complication during cataract surgery. SETTING: Ten ophthalmic surgery departments in Sweden. METHODS: Consecutive cataract extractions with a reported capsule complication were selected from the national database. Surgical data and data from the matching ophthalmic records at the participating clinics were analyzed. Controls were selected as the first uneventful procedure in the database after each procedure with a complication. RESULTS: Data on 655 cataract extractions were studied for evaluation of risks and additional care; a capsule complication occurred in 324 procedures and no complication in 331 procedures. Using these records, 369 patients were recruited for a follow-up examination of the outcomes 3 years after the original cataract extraction. The records showed a substantial increase in additional care after a capsule complication, including more visits after surgery, increased need for in-patient care, and a significantly greater percentage of reoperations than after the uneventful surgery. With additional care, the average cost of a procedure with a capsule complication was approximately double the cost of an uneventful cataract extraction. CONCLUSIONS: The combined study of the database and matching medical records showed a substantial increase in additional care after a capsule complication. Using the database allowed identification of a large number of capsule complication cases and uneventful cases, indicating that national databases are excellent sources of data for studying unusual complications.

  • 70. Lundström, M
    et al.
    Brege, K G
    Florén, I
    Lundh, Björn
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för nervsystem och rörelseorgan, Oftalmologi. Östergötlands Läns Landsting, Rekonstruktionscentrum, Ögonkliniken US/LiM.
    Stenevi, U
    Thorburn, W
    Cataract surgery and quality of life in patients with age related macular degeneration2002Ingår i: British Journal of Ophthalmology, ISSN 0007-1161, E-ISSN 1468-2079, Vol. 86, nr 12, s. 1330-1335Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background: The coexistence of cataract and age related macular degeneration (AMD) is not unusual, especially in the very elderly. The outcome of cataract surgery in these cases depends on the effect of AMD on vision. In this study the authors have compared the outcome of cataract patients with AMD to that of cataract patients with no vision threatening ocular comorbidity, and analysed possible predictors of good or poor outcome. Methods: An observational prospective study on consecutive cases operated for cataract during 1 month at six surgical departments affiliated to the Swedish National Cataract Register (NCR). Data were collected according to the protocol of NCR and subjects completed the Catquest questionnaire before and 6 months after surgery. 90 subjects with AMD were compared to 335 subjects with no sight threatening ocular comorbidity. Results: Difficulties in performing various daily life activities improved significantly for AMD subjects after surgery (p<0.001, Wilcoxon signed rank test). Satisfaction with vision also improved significantly after surgery (p<0.001, Wilcoxon signed rank test). Activity level and independence were unchanged. Subjects with no ocular comorbidity had a still better outcome. The most important variable related to a good self assessed functional outcome was postoperative visual acuity irrespective of the presence of AMD. AMD subjects scheduled for second eye surgery and AMD subjects dissatisfied with their vision before surgery had a poorer outcome. Conclusion: Subjects with various stages of dry AMD and cataract improved their self assessed visual function and satisfaction with vision significantly after cataract extraction.

  • 71. Magnusson, Gunilla
    et al.
    Jakobsson, Peter
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för nervsystem och rörelseorgan, Oftalmologi. Östergötlands Läns Landsting, Rekonstruktionscentrum, Ögonkliniken US/LiM.
    Kugelberg, U
    Lundvall, A
    Maly, E
    Tornqvist, K
    Abrahamsson, M
    Andreasson, B
    Borres, Magnus
    Broberger, U
    Hellström-Westas, L
    Kornfält, R
    Nelson, Nina
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för molekylär och klinisk medicin, Pediatrik. Östergötlands Läns Landsting, Barn- och kvinnocentrum, Barn.
    Sjöstrand, J
    Thiringer, Klara
    Evaluation of screening procedures for congenital cataracts2003Ingår i: Acta Paediatrica, ISSN 0803-5253, E-ISSN 1651-2227, Vol. 92, nr 12, s. 1468-1473Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Aim: To evaluate the efficacy of two different Swedish screening procedures for early detection of congenital cataracts in comparison with no screening. Methods: Children born between January 1992 and December 1998 in Swedish regions with an established eye-screening routine procedure, diagnosed with congenital cataract, and operated on before 1 y of age, were included in a retrospective study. Age at referral and age at time of the operation were compared between regions using different screening procedures: screening in the maternity wards (Region 1), at the well-baby clinics (Region 2) and one region without any screening (Region 3). Results: Seventy-two children were included in the study. Concerning early diagnosis and surgery, Region 1 differed significantly from Regions 2 and 3, which were more similar and were combined for further analysis. The difference in detected cases was greatest at 21 d of age (55% vs 18%, p < 0.001), but persisted even at 100 d of age (78% vs 64%, p < 0.02). Region 1 screening resulted in more and earlier cases detected than the other two regions (22 vs 15 per 100 000 births). In 72% of all cases, surgery was performed in response to referrals from either the maternity wards (36%), or the well-baby clinics (36%). However, half of the cases from the well-baby clinics were detected too late, i.e. at >100 d. Conclusion: Eye screening in the maternity ward is preferable to well-baby clinic screening and to no screening at all, since it leads to early detection. Screening should also be performed routinely at well-baby clinics within the period when successful treatment is possible.

  • 72. Merrett, Kimberley
    et al.
    Fagerholm, Per
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för klinisk och experimentell medicin, Oftalmologi. Östergötlands Läns Landsting, Rekonstruktionscentrum, Ögonkliniken US/LiM.
    McLaughlin, Christopher R.
    Univ Ottawa, Dept Cellular & Mol Med, Ottawa, ON, Canada.
    Dravida, Subhadra
    Lagali, Neil
    University of Ottawa.
    Shinozaki, Naoshi
    Tokyo Dent Coll, Cornea Ctr & Eye Bank, Chiba, Japan.
    Watsky, Mitchell A.
    Univ Tennessee, Ctr Hlth Sci, Dept Physiol, Memphis, TN 38163 USA.
    Munger, Rejean
    Kato, Yasuhiro
    Tokyo Dent Coll, Cornea Ctr & Eye Bank, Chiba, Japan.
    Li, Fengfu
    Marmo, Christopher J.
    CooperVision Inc, Pleasanton, CA USA.
    Griffith, May
    Univ Ottawa, Dept Cellular & Mol Med, Ottawa, ON, Canada.
    Tissue-engineered recombinant human collagen-based corneal substitutes for implantation: Performance of type I versus type III collagen2008Ingår i: Investigative Ophthalmology and Visual Science, ISSN 0146-0404, E-ISSN 1552-5783, Vol. 49, nr 9, s. 3887-3894Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    PURPOSE. To compare the efficacies of recombinant human collagens types I and III as corneal substitutes for implantation. METHODS. Recombinant human collagen (13.7%) type I or III was thoroughly mixed with 1-ethyl-3-(3-dimethylaminopropyl) carbodiimide and N-hydroxysuccinimide. The final homogenous solution was either molded into sheets for in vitro studies or into implants with the appropriate corneal dimensions for transplantation into minipigs. Animals with implants were observed for up to 12 months after surgery. Clinical examinations of the cornea included detailed slit lamp biomicroscopy, in vivo confocal microscopy, and fundus examination. Histopathologic examinations were also performed on corneas harvested after 12 months. RESULTS. Both cross-linked recombinant collagens had refractive indices of 1.35, with optical clarity similar to that in human corneas. Their chemical and mechanical properties were similar, although RHC-III implants showed superior optical clarity. Implants into pig corneas over 12 months show comparably stable integration, with regeneration of corneal cells, tear film, and nerves. Optical clarity was also maintained in both implants, as evidenced by fundus examination. CONCLUSIONS. Both RHC-I and -III implants can be safely and stably integrated into host corneas. The simple cross-linking methodology and recombinant source of materials makes them potentially safe and effective future corneal matrix substitutes.

  • 73. Narfström, K
    et al.
    Wrigstad, Anders
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för nervsystem och rörelseorgan, Oftalmologi. Östergötlands Läns Landsting, Rekonstruktionscentrum, Ögonkliniken US/LiM.
    Clinical, electrophysiological and morphological changes in a case of hereditary retinal degeneration in the Papillon dog.1999Ingår i: Veterinary Ophthalmology, ISSN 1463-5216, E-ISSN 1463-5224, Vol. 2, s. 67-74Artikel i tidskrift (Refereegranskat)
  • 74.
    Neira, Waldir
    et al.
    University of Helsinki.
    Hammar, Bjorn
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Oftalmologi. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Rekonstruktionscentrum, Ögonkliniken US/LiM.
    M Holopainen, Juha
    University of Helsinki.
    Tuisku, Ilpo
    University of Helsinki.
    Dellby, Anette
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Oftalmologi. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Rekonstruktionscentrum, Ögonkliniken US/LiM.
    Tervo, Timo
    University of Helsinki.
    Fagerholm, Per
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Oftalmologi. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Rekonstruktionscentrum, Ögonkliniken US/LiM.
    Dystrophia Helsinglandica - corneal morphology, topography and sensitivity in a hereditary corneal disease with recurrent erosive episodes2010Ingår i: ACTA OPHTHALMOLOGICA, ISSN 1755-375X, Vol. 88, nr 4, s. 401-406Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Purpose: The aim of this study was to describe the morphology, corneal topography and sensitivity in individuals with Dystrophia Helsinglandica. This autosomal dominant corneal disease is characterized by recurrent corneal erosive episodes and progressive subepithelial fibrosis not significantly affecting visual acuity. Methods: The corneas of nine affected and nine unaffected individuals were examined using slit-lamp biomicroscopy, in vivo confocal microscopy (IVCM) and videokeratography. Corneal mechanical sensitivity was also measured using a non-contact esthesiometer. Results: Slit-lamp biomicroscopy revealed that the affected individuals represented different stages of corneal changes, from a nearly normal cornea to subepithelial fibrosis of the central cornea. Corneal changes in affected individuals did not significantly decrease the best spectacle-corrected visual acuity. In vivo confocal microscopy detected morphological changes in the epithelium and stroma. Subepithelial opacity formation including altered keratocytes could be found in the anterior stroma in all affected eyes. With the exception of two eyes (one affected and one unaffected), all videokeratographies showed irregular astigmatism. Corneal sensitivity was significantly lower in affected individuals (p = 0.01). Age and corneal sensitivity showed no correlation. Conclusion: The main morphological findings in affected individuals were discrete and progressive subepithelial fibrosis, in the in vivo confocal microscope corresponding to optically dense extracellular matrix and activated keratocytes. Subbasal nerve morphology was changed in the affected family members who also showed a decreased corneal sensitivity. The findings are per se not specific to the disease. The changes probably reflect a healing response to erosive events on the corneal surface influenced by the genotype.

  • 75.
    Neira, Waldir
    et al.
    Department of Ophthalmology, University of Helsinki, Helsinki, Finland.
    Hammar, Björn
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Oftalmologi. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Rekonstruktionscentrum, Ögonkliniken US/LiM.
    Holopainen, Juha M.
    Department of Ophthalmology, University of Helsinki, Helsinki, Finland.
    Tuisku, Ilpo
    Department of Ophthalmology, University of Helsinki, Helsinki, Finland.
    Dellby, Anette
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Oftalmologi. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Rekonstruktionscentrum, Ögonkliniken US/LiM.
    Tervo, Timo
    Department of Ophthalmology, University of Helsinki, Helsinki, Finland.
    Fagerholm, Per
    Linköpings universitet, Institutionen för klinisk och experimentell medicin, Oftalmologi. Linköpings universitet, Hälsouniversitetet. Östergötlands Läns Landsting, Rekonstruktionscentrum, Ögonkliniken US/LiM.
    Dystrophia Helsinglandica: corneal morphology, topography and sensitivity in a hereditary corneal disease with recurrent erosive episodesManuskript (preprint) (Övrigt vetenskapligt)
    Abstract [en]

    Purpose: The aim of this study was to describe the morphology, corneal topography and sensitivity in individuals with Dystrophia Helsinglandica. This autosomal dominant corneal disease is characterized by recurrent corneal erosive episodes and progressive subepithelial fibrosis not significantly affecting visual acuity.

    Methods: The corneas of nine affected and nine unaffected individuals were examined using slit‐lamp biomicroscopy, in‐vivo confocal microscopy, and videokeratography. Corneal mechanical sensitivity was also measured using a noncontact esthesiometer.

    Results: Slit‐lamp biomicroscopy revealed that the affected individuals represented different stages of corneal changes, from a nearly normal cornea to subepithelial fibrosis of the central cornea. Corneal changes in affected individuals did not significantly decrease the best spectacle‐corrected visual acuity. In‐vivo confocal microscopy detected morphological changes in the epithelium and stroma. Subepithelial opacity formation including altered keratocytes could be found in the anterior stroma in all affected eyes. With the exception of two eyes (one affected and one unaffected), all videokeratographies showed irregular astigmatism. Corneal sensitivity was significantly lower in affected individuals (p ≤0.01). Age and corneal sensitivity showed no correlation.

    Conclusion: The main morphological findings in affected individuals were discrete and progressive subepithelial fibrosis, in the in‐vivo confocal microscope corresponding to optically dense extracellular matrix and activated keratocytes. Subbasal nerve morphology was changed in the affected family members who also showed a decreased corneal sensitivity. The findings were per se not specific to the disease. The changes probably reflect a healing response to erosive events on the corneal surface influenced by the genotype.

  • 76.
    Nilsson, Ulla L
    et al.
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för nervsystem och rörelseorgan, Oftalmologi.
    Frennesson, Christina
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för nervsystem och rörelseorgan, Oftalmologi. Östergötlands Läns Landsting, Rekonstruktionscentrum, Ögonkliniken US/LiM.
    Nilsson, Sven Erik
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för nervsystem och rörelseorgan, Oftalmologi.
    Patients with AMD and a large absolute central scotoma can be trained successfully to use eccentric viewing, as demonstrated in a scanning laser ophthalmoscope2003Ingår i: Vision Research, ISSN 0042-6989, E-ISSN 1878-5646, Vol. 43, nr 16, s. 1777-1787Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Twenty patients with age-related macular degeneration, an absolute central scotoma and a mean visual acuity of 0.04 (20/475) were studied. A scanning laser ophthalmoscope (SLO) was used for microperimetry and determination of preferred retinal locus, often located to the left of the retinal lesion (corresponding to a location to the left of the visual field scotoma), which is considered unfavorable for reading. All 20 patients were trained to use a new and more favorable retinal locus for reading, above (or occasionally below) the retinal lesion (corresponding to a location below or above the visual field scotoma), first by reading scrolled text under simultaneous fixation monitoring and instruction in the SLO and then by reading printed text, using high magnification (mean 14.3╫). For the 18 patients who learned to use eccentric viewing, reading speed with adequate magnification prior to training was 9.0▒5.8 words/min. With training (mean 5.2 hours), it increased significantly (p<0.001) to 68.3▒19.4 words per min. Training of eccentric reading has thus proved to be very successful.

  • 77.
    Podskochy, Alexander
    et al.
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för nervsystem och rörelseorgan, Oftalmologi.
    Fagerholm, Per
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för nervsystem och rörelseorgan, Oftalmologi. Östergötlands Läns Landsting, Rekonstruktionscentrum, Ögonkliniken US/LiM.
    Repeated UVR exposures cause keratocyte resistance to apoptosis and hyaluronan accumulation in the rabbit cornea2001Ingår i: Acta Ophthalmologica Scandinavica, ISSN 1395-3907, E-ISSN 1600-0420, Vol. 79, nr 6, s. 603-608Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Purpose: To evaluate hyaluronan (HA) production and level of apoptosis of corneal cells after repeated UVR exposures. Methods: Fifteen albino rabbit corneas were exposed to 310 nm UVR at a dose that causes biomicroscopically significant keratitis (0.47 J/cm2). Nine rabbits received a single dose of UVR. Six rabbits were irradiated 3 times at 7-day intervals. Rabbits exposed to the single dose of UVR, were sacrificed 24 hours, 7 and 14 days after irradiation. Rabbits exposed to the repeated doses of UVR, were sacrificed 24 hours and 14 days after the last irradiation. The corneal tissue specimens were processed for histological analysis using specific staining for HA, and the TdT-dUTP terminal nick-end labeling (TUNEL) assay. Results: Corneas exposed to a single UVR dose showed extensive positive TUNEL staining 24 hours after exposure. Almost all basal epithelial cells, keratocytes throughout the entire thickness of the stroma, and endothelial cells were TUNEL-positive. No HA was found 24 hours after exposure. Extracellular HA staining of high intensity was found at day 7 throughout the entire central stroma, except the anterior one-fourth. At day 14 only a faint HA staining was detected in the posterior stroma, close to Descemet's membrane. Corneas exposed to repeated UVR doses showed at 24 hours positive TUNEL staining only in epithelial cells and in very few stromal cells. The majority of stromal cells and endothelial cells were unaffected. At the same time HA staining of very high intensity was found both at 24 hours and day 14, and it was evenly distributed throughout the entire thickness of the stroma. Conclusion: Repeated UVR exposures lead to increased production and accumulation of HA in the corneal stroma. The repopulated keratocytes are much more resistant to apoptosis than the native ones. HA accumulation may be a sign of long-term changes in the cornea.

  • 78.
    Podskochy, Alexander
    et al.
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för klinisk och experimentell medicin, Oftalmologi. Östergötlands Läns Landsting, Rekonstruktionscentrum, Ögonkliniken US/LiM.
    Koulikovska, Marina
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för klinisk och experimentell medicin, Oftalmologi. Östergötlands Läns Landsting, Rekonstruktionscentrum, Ögonkliniken US/LiM.
    Fagerholm, Per
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för klinisk och experimentell medicin, Oftalmologi. Östergötlands Läns Landsting, Rekonstruktionscentrum, Ögonkliniken US/LiM.
    Expression of alpha-smooth muscle actin during wound healing in UVR-exposed rabbit corneas2003Ingår i: Investigative Ophthalmology and Visual Science, ISSN 0146-0404, E-ISSN 1552-5783, Vol. 44, s. 889-Konferensbidrag (Övrigt vetenskapligt)
  • 79.
    Podskochy, Alexander
    et al.
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för klinisk och experimentell medicin, Oftalmologi. Östergötlands Läns Landsting, Rekonstruktionscentrum, Ögonkliniken US/LiM.
    Koulikovska, Marina
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för klinisk och experimentell medicin, Oftalmologi. Östergötlands Läns Landsting, Rekonstruktionscentrum, Ögonkliniken US/LiM.
    Fagerholm, Per
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för klinisk och experimentell medicin, Oftalmologi. Östergötlands Läns Landsting, Rekonstruktionscentrum, Ögonkliniken US/LiM.
    van der Ploeg, I
    Expression of proteoglycan biglycan in UV-exposed rabbit corneas.2001Ingår i: Investigative Ophthalmology and Visual Science, ISSN 0146-0404, E-ISSN 1552-5783, Vol. 42, nr 4, s. 4769-Konferensbidrag (Övrigt vetenskapligt)
  • 80.
    Sundelin, Staffan
    et al.
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för klinisk och experimentell medicin, Oftalmologi. Östergötlands Läns Landsting, Rekonstruktionscentrum, Ögonkliniken US/LiM.
    Nilsson, SEG
    Brunk, Ulf
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för medicin och hälsa, Farmakologi.
    Lipofuscin accumulation in cultured retinal pigment epithelial cells is dependent on the melanin content2000Ingår i: Investigative Ophthalmology and Visual Science, ISSN 0146-0404, E-ISSN 1552-5783, Vol. 41, nr 4, s. 4472B419-Konferensbidrag (Övrigt vetenskapligt)
  • 81. Veske, A.
    et al.
    Nilsson, Sven Erik
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för nervsystem och rörelseorgan, Oftalmologi. Östergötlands Läns Landsting, Rekonstruktionscentrum, Ögonkliniken US/LiM.
    Narfström, K
    Gal, A.
    Retinal dystrophy of swedish Briard/Briard-Beagle dogs is due to a 4-bp deletion in RPE65.1999Ingår i: Genomics, ISSN 0888-7543, E-ISSN 1089-8646, Vol. 57, s. 57-61Artikel i tidskrift (Refereegranskat)
  • 82. Weber, Beat A
    et al.
    Gan, Lisha
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för nervsystem och rörelseorgan, Oftalmologi. Östergötlands Läns Landsting, Rekonstruktionscentrum, Ögonkliniken US/LiM.
    Fagerholm, Per
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för nervsystem och rörelseorgan, Oftalmologi. Östergötlands Läns Landsting, Rekonstruktionscentrum, Ögonkliniken US/LiM.
    Short-term impact of corticosteroids on hyaluronan and epithelial hyperplasia in the rabbit cornea after photorefractive keratectomy2001Ingår i: Cornea, ISSN 0277-3740, E-ISSN 1536-4798, Vol. 20, nr 3, s. 321-324Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Purpose. To investigate the impact of corticosteroids on subepithelial hyaluronan deposition and corneal epithelium thickness in the first 10 days after photorefractive keratectomy (PRK) and to analyze a possible contralateral effect of corticosteroids. Methods. Thirty-two New Zealand white rabbits were assigned into two groups and had a transepithelial 5.0-mm diameter, 8.00-diopter myopic PRK performed on one eye. The corticosteroid treatment group (16 animals) received 0.1 mL of methylprednisolone 4% subconjunctivally on the operation table, followed by 0.1% dexamethasone eye drops six times a day during the postoperative period. The sodium chloride (NaCl) treatment group received topical isotonic NaCl eye drops six times a day. In each treatment group, eight animals were killed after 3 and 9 days, respectively. The harvested specimens were stained for hyaluronan and the epithelial thickness was measured. Results. In contrast to the epithelial thickness, the subepithelial hyaluronan did not show a significant increase during the observation period. The corticosteroid treated group showed at both time-points significantly less subepithelial hyaluronan formation as well as a significantly thinner epithelium, when compared with the NaCl-treated group. At 9 days, the corticosteroid-treated group showed a mild epithelial hyperplasia in only one of eight eyes, whereas this was a common finding in the NaCl-treated group. We detected no hyaluronan deposits in any contralateral-untreated eye, and the epithelial thickness did not differ significantly between any of the four contralateral-untreated eye groups. Conclusions. Corticosteroid medication during the first 10 days after operation reduces the amount of subepithelial hyaluronan production and inhibits the epithelial proliferation, and epithelial hyperplasia is prevented. Neither a contralateral hyaluronan deposition nor a contralateral corticosteroid effect could be detected.

  • 83. Weber, Beat A
    et al.
    Gan, Lisha
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för nervsystem och rörelseorgan, Oftalmologi. Östergötlands Läns Landsting, Rekonstruktionscentrum, Ögonkliniken US/LiM.
    Fagerholm, Per
    Linköpings universitet, Hälsouniversitetet. Linköpings universitet, Institutionen för nervsystem och rörelseorgan, Oftalmologi. Östergötlands Läns Landsting, Rekonstruktionscentrum, Ögonkliniken US/LiM.
    Wound healing response in the presence of stromal irregularities after excimer laser treatment2001Ingår i: Acta Ophthalmologica Scandinavica, ISSN 1395-3907, E-ISSN 1600-0420, Vol. 79, nr 4, s. 381-388Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Purpose: To trace the fate of stromal irregularities after excimer laser treatment and to increase our knowledge of the reasons why surface irregularities in the ablation bed cause inferior postoperative results. Methods: Twelve New Zealand White rabbits received a transepithelial photoablation to a preset depth of 60 ╡m. An electron microscopy specimen grid was then placed on the denuded stroma and another 20 ╡m ablation was applied in order to produce surface irregularities. Another six rabbits received a plano transepithelial photoablation to a preset depth of 80 ╡m. The treated corneas were harvested at various timepoints and differentially further processed for microradiography, hematoxylin-eosin-, hyaluronan (HA)- and leukocyte protein L1 staining. Results: In the grid treated corneas the subepithelial mesh pattern is clearly discernible after 1 week, and after 4 weeks it is replaced by a subepithelial layer containing HA and water. The thinning of this layer between 1 and 12 weeks is statistically significant (p<0.05). After 4 and 8 week the plano treated corneas only exhibit some subepithelial HA- and water accumulation. After 1 day the grid treated corneas show an extensive stromal infiltration of leukocytes. In the plano treated corneas the leukocytes mainly remain on the surface. Conclusions: During the healing process stromal irregularities are flattened, leaving a homogeneous zone with increased water content. This subepithelial layer is rarefying as new subepithelial tissue is forming. Postablational irregularities induce a more pronounced healing reaction when compared to a smooth ablation surface. Leukocyte infiltration seems to play a role in this process.

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