Liv Kari Drolsum

• Thorbjørnsen, Bjarne Løberg; Velle-Skretteberg, Marthe Andrea; Thorsrud, Andreas; Sæthre, Marit; Østern, Atle Einar & Drolsum, Liv Kari [Show all 7 contributors for this article] (2025). Infectious keratitis after corneal cross-linking: A retrospective case series. Cornea. ISSN 0277-3740. p. 1–6. doi: https:/journals.lww.com/corneajrnl/fulltext/9900/infectious_keratitis_after_corneal_cross_linking_.899.aspx. Full text in Research Archive Show summary

  Purpose: To evaluate the risk of infectious keratitis after corneal cross-linking (CXL) in eyes with corneal ectasia. Methods: In this retrospective case series, we reviewed the medical records of patients with a diagnosis code for keratitis over a 6-month period after all CXLs performed in the Department of Ophthalmology at Oslo University Hospital from 2007 to 2020. To compare our results with the existing literature, we reviewed studies evaluating the risk of keratitis after CXL. Results: A total of 1809 CXLs were performed in our department during the study period. The annual number of CXLs increased from 3 in 2007 to 219 in 2020. We identified 11 (0.6%) cases registered with a keratitis code within 6 months after CXL, of which the physician considered five (0.3%, 95% CI: 0.1%–0.6%) to be a procedure-related infectious keratitis. The microbiological agents were Staphylococcus aureus (n=3), Acanthamoebae (n=1), or unknown (n=1). The literature review identified 23 relevant studies that reported infectious keratitis in 0%–2.6% of eyes after CXL treatment. To our knowledge, this is the first Scandinavian study to report the risk of infectious keratitis after CXL and the largest European study. Conclusions: We found a low incidence of infectious keratitis following CXL. Our rate was comparable to that reported in the literature, indicating a low risk of this complication in eyes with corneal ectasia treated with CXL.

• Bjerkreim, Hilde; Thorbjørnsen, Bjarne Løberg; Nærland, Terje; Drolsum, Liv Kari & Kristianslund, Olav (2025). Nationwide study of the association between keratoconus and autism spectrum disorder. Journal of cataract and refractive surgery. ISSN 0886-3350. 51(12), p. 1057–1062. doi: 10.1097/j.jcrs.0000000000001740. Full text in Research Archive Show summary

  Purpose: To examine whether there was an association between keratoconus and autism spectrum disorder (ASD) in Norway and compare with the general population. Setting: The total population of Norway, including all individuals with ASD and keratoconus. Design: Cross-sectional epidemiological study. Methods: Data were obtained from the Norwegian Patient Registry, which provides information from all publicly funded specialist care. The keratoconus prevalence among persons with ASD was estimated from the total number of individuals with keratoconus in the period 2010-2019 and compared with the prevalence in the general population of Norway during the same period. Results: A population-based sample in Norway identified 23 763 persons with ASD, equivalent to 0.5% of the population, and of these, 115 (0.5%) had a diagnosis of keratoconus. The average age at keratoconus diagnosis among individuals with ASD was 27.3 years, and 83.5% of those diagnosed with both ASD and keratoconus were men. During the same period, the prevalence of keratoconus in the general population of Norway was 0.2%, resulting in an odds ratio of 2.5 (95% CI 2.0-3.0). Conclusions: Based on our findings, people with ASD have significantly higher prevalence of keratoconus compared with the general population of Norway. This implicates that one should have increased awareness for keratoconus and low threshold for corneal tomography in patients with ASD.

• Sund, Martin Harvey; Slettedal, Jon Klokk; Sæthre, Marit; Haslev, Hans Petter; Kristianslund, Olav & Østern, Atle Einar [Show all 7 contributors for this article] (2024). Incidence, risk factors, and patient characteristics in severe contact lens-related microbial keratitis. Acta Ophthalmologica. ISSN 1755-375X. 103(3), p. 289–294. doi: 10.1111/aos.16796. Full text in Research Archive Show summary

  Purpose The aim of the present study was to determine the incidence, patient characteristics, and risk factors for severe, contact lens-related keratitis in patients in need of hospitalization. Methods Keratitis was defined as severe when the disease required hospitalization. All patients with contact lens-related keratitis hospitalized at our department between 1 January 2018 and 31 December 2020 were interviewed with a questionnaire, about their use of contact lenses and knowledge of complications. Clinical information was collected from the medical records. Results A total of 41 patients (42 eyes) were hospitalized with severe keratitis during the 3-year period. The yearly incidence was 2.52 per 10 000 contact lens users over the age of 15 for extended-wear lenses used overnight, and 0.52 per 10 000 for users of daily disposable contact lenses. Pseudomonas aeruginosa was the most frequently isolated microbe. The median age was 50 years (range 15–66 years). Twenty-three patients (56%) were female, 28 patients (66%) used extended-wear contact lenses and 12 patients (29%) used daily disposable lenses. Nineteen patients (45%) admitted improper use. The median duration of contact lens use was 11.5 years. Only 15 patients (37%) had knowledge of keratitis as a potential complication. Conclusion Most patients were experienced contact lens users. Users of extended-wear contact lenses worn overnight had a significantly higher risk of severe microbial keratitis. More focus on information and education of the risk of keratitis in contact lens users is needed.

• HAGEM, ANNE MARIE; Thorsrud, Andreas; Sæthre, Marit; Sandvik, Gunhild Falleth; Kristianslund, Olav & Drolsum, Liv Kari (2023). Dramatic Reduction in Corneal Transplants for Keratoconus 15 Years After the Introduction of Corneal Collagen Crosslinking. Cornea. ISSN 0277-3740. 43(4), p. 437–442. doi: 10.1097/ICO.0000000000003401. Full text in Research Archive
• Bisevac, Jovana; Moe, Morten Carsten; Drolsum, Liv Kari; Kristianslund, Olav; Petrovski, Goran & noer, agate (2023). A Novel Technique of Amniotic Membrane Preparation Mimicking Limbal Epithelial Crypts Enhances the Number of Progenitor Cells upon Expansion. Cells. 12(5). doi: 10.3390/cells12050738. Full text in Research Archive Show summary

  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.

• Bøhler, Anders Djupesland; Traustadottir, Valgerdur Dora; HAGEM, ANNE MARIE; Tønseth, Turid Skei; Drolsum, Liv Kari & Kristianslund, Olav (2023). Hypotony in the early postoperative period after MicroShunt implantation versus trabeculectomy: A registry study. Acta Ophthalmologica. ISSN 1755-375X. doi: 10.1111/aos.15727. Full text in Research Archive Show summary

  Abstract 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.

• Medin, Ingvild Helle; Kure, Ingeborg Slørdahl Hjort; Dalby, Marius; Kristianslund, Olav & Drolsum, Liv Kari (2023). Inflammatory reaction in eyes with late in-the-bag intraocular lens dislocation. Acta Ophthalmologica. ISSN 1755-375X. 102(3). doi: 10.1111/aos.15720. Full text in Research Archive Show summary

  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.

• Sand, Mari Kathrine; Cholidis, Symira; Kristianslund, Olav & Drolsum, Liv Kari (2023). Bag-in-the-lens intraocular lens implantation before 12 weeks of age in congenital cataract. Acta Ophthalmologica. ISSN 1755-375X. doi: 10.1111/aos.15647. Full text in Research Archive
• Kvernebo, Anne Kari; Moe, Morten Carsten; Sundheim, Liv Kristin Ribbskog; Capone, Luigino; Drolsum, Liv Kari & Kvernebo, Knut (2022). Human ocular surface microcirculation quantified by in vivo computer assisted video microscopy and diffuse reflectance spectroscopy. Experimental Eye Research. ISSN 0014-4835. 224, p. 1–6. doi: 10.1016/j.exer.2022.109232. Full text in Research Archive Show summary

  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.

• Sand, Mari Kathrine; Cholidis, Symira; Kristianslund, Olav & Drolsum, Liv Kari (2022). Primary intraocular lens implantation in infants with unilateral congenital cataract operated before 12 weeks of age. Acta Ophthalmologica. ISSN 1755-375X. 100(5), p. 526–533. doi: 10.1111/aos.15155. Full text in Research Archive Show summary

  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.

• Medin, Ingvild Helle; Dalby, Marius; Kure, Ingeborg Slørdahl Hjort; Karabeg, Mia; Drolsum, Liv Kari & Kristianslund, Olav (2022). Intraocular Inflammation in Eyes Operated for Late In-the-bag intraOcular lens dislocatioN (LION): A Randomized Clinical Trial. American Journal of Ophthalmology. ISSN 0002-9394. 238, p. 66–74. doi: 10.1016/j.ajo.2021.12.019. Full text in Research Archive Show summary

  PURPOSE To compare the intraocular inflammation after 2 surgical approaches for late in-the-bag intraocular lens (IOL) dislocation. DESIGN Prospective, randomized, parallel-group clinical trial. METHODS We randomly assigned 100 patients (100 eyes) referred to Oslo University Hospital (tertiary referral center) with late in-the-bag IOL dislocation into IOL repositioning by scleral suturing (n=49) or IOL exchange with retropupillary fixation of an iris-claw lens (n=51). Patients were examined before surgery and 2 weeks, 6 weeks, and 6 months after surgery. The main outcome measure was anterior chamber laser flare, measured with a laser flare meter as photon counts per millisecond (pc/ms). RESULTS Two weeks following surgery, median flare values were 28.9 pc/ms (range, 7.9-140) in the repositioning group and 31.6 pc/ms (range, 9.8-92.3) in the exchange group (P = .83). Flare levels were still elevated after 6 weeks with no difference between the groups (P = .93), whereas it decreased to baseline levels after 6 months. Six weeks following surgery, the central retinal thickness was similar (P = .97); cystoid macular edema (CME) was found in 4 and 5 patients, respectively (P = .85); and the mean best corrected visual acuity was 0.17 (95% CI 0.09, 0.25) and 0.21 (95% CI 0.09, 0.32) logarithm of the minimum angle of resolution, respectively (P = .61). CONCLUSIONS This study revealed similar levels of intraocular inflammation following IOL repositioning and IOL exchange. There was no significant difference regarding risk of CME and visual outcome. The prolonged elevation in postoperative flare indicates a possible requirement for an extended anti-inflammatory treatment period after these operations.

• Medin, Ingvild Helle; Kure, Ingeborg Slørdahl Hjort; Dalby, Marius; Drolsum, Liv Kari & Kristianslund, Olav (2022). Long-term risk of suture breakage after scleral fixation of late in-the-bag intraocular lens dislocation with a polypropylene 10-0 suture. Journal of cataract and refractive surgery. ISSN 0886-3350. 48(12), p. 1408–1412. doi: 10.1097/j.jcrs.0000000000001010. Full text in Research Archive Show summary

  Purpose: To investigate the long-term risk of suture breakage after scleral fixation with a polypropylene 10-0 suture in eyes with late in-the-bag intraocular lens (IOL) dislocation. Setting: Oslo University Hospital, Oslo, Norway. Design: Retrospective case series. Methods: Patients operated with scleral suturing of late in-the-bag IOL dislocation from 2007 to 2016. 192 eyes (176 patients) operated with scleral suture (polypropylene 10-0 suture) fixation of a dislocated IOL-capsule complex were identified; 91 patients (47%) were men. Results: The mean follow-up after the operation was 6.2 (95% CI, 5.7-6.7) years, and 98 patients (56%) deceased during the study. 11 eyes (6%) (11 patients) had suture breakage that required reoperation with a mean time of 5.5 (3.4-7.6) years after IOL repositioning surgery. These patients had a mean age of 73.5 (67.9-79.2) years at the time of the operation for late in-the-bag IOL dislocation vs 81.3 (79.8-82.9) years for patients who did not experience this complication (P = .004). No cases of late endophthalmitis were registered. Conclusions: The long-term risk of suture breakage was quite low after scleral fixation of late in-the-bag IOL dislocation, particularly in the oldest patients. Hence, the polypropylene 10-0 suture seems to be a safe option for scleral fixation in this patient group.

• Kristianslund, Olav; Hassaf, Safia Esmail & Drolsum, Liv Kari (2022). Optical Biometry and Lens Power Calculations in 500 Phakic Patients: Axial Length and Corneal Curvature in the Fellow Eye. Clinical Ophthalmology. ISSN 1177-5467. 16, p. 2775–2780. doi: 10.2147/OPTH.S375743. Full text in Research Archive Show summary

  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.

• Sandvik, Gunhild Falleth; Rand-Hendriksen, Svend; Drolsum, Liv Kari & Kristianslund, Olav (2021). Pupillary response in adults with Marfan syndrome and its effect on straylight. Acta Ophthalmologica. ISSN 1755-375X. doi: 10.1111/aos.15079. Full text in Research Archive Show summary

  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.

• Kvernebo, Anne Kari; Miyamoto, Takuma; Drolsum, Liv Kari; Moe, Morten Carsten; Måsøy, Svein-Erik & Sunagawa, Gengo [Show all 10 contributors for this article] (2021). Ocular surface microcirculation is better preserved with pulsatile versus continuous flow during cardiopulmonary bypass—An experimental pilot. Artificial Organs. ISSN 0160-564X. doi: 10.1111/aor.14137. Full text in Research Archive Show summary

  Background: Non- pulsatile cardiopulmonary bypass (CPB) may induce micro-vascular 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 ex-amined 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 deterio-rated 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 pre-served with pulsatile versus CF during 6 h of CPB in sleeping piglets.

• Tønseth, Turid Skei; Jakobsen, Jan Erik; Tveit, Jon Henrik; Jørstad, Anna-Katharina; Brevik, Tone Beate & Sten, Lotte-Guri Bogfjellmo [Show all 7 contributors for this article] (2021). Circumferential (360°) trabeculotomy in primary congenital glaucoma: 19–245 months of follow-up. Acta Ophthalmologica. ISSN 1755-375X. 9(8), p. 1–9. doi: 10.1111/aos.14846. Full text in Research Archive Show summary

  Purpose: To evaluate the long-term efficacy and safety of circumferential trabeculotomy (CT) in the treatment of primary congenital glaucoma (PCG). Methods: Retrospective, single-institutional case series of CT performed for PCG in years 1997–2016. The surgery could be completed in 42 out of 65 eyes (65%) intended for CT, and 39 of them were included in the study. A follow-up examination was performed in 2017. Success was defined as intraocular pressure ≤ 16 mmHg without (complete) or with (qualified) glaucoma medication. Results: Complete success was obtained in 33/39 eyes (85%), qualified success in 34/39 eyes (87%). Of the 39 eyes with CT, 4 eyes (10%) needed additional surgery. Median follow-up time was 120 months (range, 19–245 months). Median pre- and postoperative IOP were 26.0 mmHg (range, 10–41 mmHg) and 11.0 mmHg (range, 8–19 mmHg), respectively (p < 0.001). Cup-disc ratio was ≥0.5 in 82% at baseline, at follow-up in 9%. The median distance corrected visual acuity at follow-up was logMAR 0.06 (range, −0.2 to 1.1). Median number of glaucoma medication at follow-up was 0 (range, 0–2), at baseline 1.0 (range, 0–2). No serious complications were noted. Conclusion: Circumferential trabeculotomy is an efficacious, safe and medication saving surgical treatment for PCG in the long term. After a median follow-up of 10 years (120 months), the morphological status of the optic nerve was either normalized or stabilized, and the visual acuity overall well preserved.

• Kristianslund, Olav & Drolsum, Liv Kari (2021). Prevalence of keratoconus in persons with down syndrome: A review. BMJ Open Ophthalmology. 6:e000754, p. 1–5. doi: 10.1136/bmjophth-2021-000754. Full text in Research Archive Show summary

  Purpose Keratoconus is a vision-threatening condition, and there is a need for knowledge about the occurrence in subgroups of the population. The progression of the disease can be effectively stopped, and vision may be restored, if keratoconus is diagnosed at an early stage. The purpose of this review was to evaluate the literature of the prevalence of keratoconus in persons with Down syndrome. Methods We conducted a literature review of keratoconus prevalence in persons with Down syndrome. A thorough search was performed in Pubmed (Medline), and the quality of evidence was evaluated. Results The literature review identified 20 relevant studies, which reported keratoconus in 0%–71% of persons with Down syndrome. These studies varied greatly in design, patient selection, sample sizes and mean age, and the quality of evidence concerning estimates for the prevalence of keratoconus was generally evaluated as low. Most studies that included adults reported high prevalences of keratoconus–in many studies more than 10-fold the prevalence in the general population. No large screening studies in persons with Down syndrome were identified. Conclusions The present review showed that the prevalence of keratoconus in persons with Down syndrome is higher than in the general population. However, estimates from previous studies vary widely. Screening for keratoconus in this group should be considered.

• Kristianslund, Olav; Tovås, Linn Cesilie; Thorsrud, Andreas & Drolsum, Liv (2021). Keratokonus forekommer hyppigere enn antatt. Tidsskrift for Den norske legeforening (Tidsskriftet). ISSN 0029-2001. 141(5), p. 1–3. doi: 10.4045/tidsskr.20.1059. Full text in Research Archive
• Kristianslund, Olav; Kure, Ingeborg Slørdahl Hjort & Drolsum, Liv (2021). Kataraktkirurgi i Norge 2010–19. Tidsskrift for Den norske legeforening (Tidsskriftet). ISSN 0029-2001. 141(9), p. 1–8. doi: 10.4045/tidsskr.20.1005. Full text in Research Archive Show summary

  BAKGRUNN Kataraktkirurgi er et svært vanlig inngrep. Formålet med denne studien var å undersøke utviklingen i antall kataraktoperasjoner i Norge og karakteristika for pasienter som har gjennomgått kataraktkirurgi i perioden 2010–19. MATERIALE OG METODE Data om kataraktoperasjoner ble innhentet fra Norsk pasientregister. Antall kataraktoperasjoner per million innbyggere ble beregnet basert på befolkningsdata fra Statistisk sentralbyrå. RESULTATER Antall kataraktoperasjoner i Norge økte fra 36 340 i 2010 til 48 291 i 2019. Dette tilsvarte en økning på 21 % fra henholdsvis 7 480 til 9 063 per million innbyggere i samme periode. Gjennomsnittsalderen var 74 år, og over 90 % var over 60 år. Andelen kataraktopererte over 60 år var tilnærmet stabil i studieperioden. Kvinner utgjorde 60 % av de kataraktopererte i 2010 og 57 % i 2019. Andelen operasjoner utført av avtalespesialister samlet for perioden varierte fra 32 % i Helse Midt-Norge til 62 % i Helse Nord. FORTOLKNING Antallet kataraktoperasjoner økte gjennom perioden, tilsvarende befolkningsøkningen i aldersgruppen over 60 år. Med videre befolkningsvekst og stadig flere eldre må man trolig planlegge for en ytterligere økning av antall kataraktoperasjoner i årene som kommer.

• Sandvik, Gunhild Falleth; Rand-Hendriksen, Svend; Drolsum, Liv & Kristianslund, Olav (2021). Photophobia and disability glare in adult patients with Marfan syndrome: a case–control study. Acta Ophthalmologica. ISSN 1755-375X. doi: 10.1111/aos.14935. Full text in Research Archive Show summary

  Purpose The aim of the present study was to investigate photophobia and disability glare in adult patients with Marfan syndrome (MFS). Methods In this case–control study, 44 patients with MFS (87 eyes) were compared to 44 controls (88 eyes), who were matched for age and sex. The subjects were asked to grade their photophobia and glare using 10-cm visual analogue scales (VAS), which were marked with ‘never’ at zero and ‘always’ at 10 -cm. In addition, disability glare was measured with C-Quant straylight meter. Results The patients with MFS had significantly higher VAS scores than the controls in four out of seven statements related to photophobia and glare. When including cataract, spherical equivalent, iris colour, axial length and corneal curvature, three of the seven statements were still significantly different between the two groups. The mean straylight values were 1.29 ± 0.03 log(s) in the MFS group and 1.01 ± 0.03 log(s) in the control group (p < 0.001, mixed model). These differences remained significant after adjusting for cataract, spherical equivalent, iris colour, axial length and corneal curvature. Conclusion Patients with MFS reported more photophobia and had a higher straylight value than the control group. Awareness of these findings of more photophobia and glare in the MFS patients is important when counselling and treating these patients.

• Kristianslund, Olav; Sandvik, Gunhild Falleth & Drolsum, Liv Kari (2021). Long-Term Suture Breakage After Scleral Fixation of a Modified Capsular Tension Ring with Polypropylene 10-0 Suture. Clinical Ophthalmology. ISSN 1177-5467. 15, p. 2473–2479. doi: 10.2147/OPTH.S310648. Full text in Research Archive Show summary

  Aim: To investigate the long-term risk of suture breakage after implantation of a modified capsular tension ring (MCTR) fixated to the sclera with polypropylene 10– 0 suture. Methods: Retrospective case series of operations for subluxated phakic lenses in 2007– 2015 with implantation of an MCTR secured with a 10– 0 polypropylene suture as part of an intraocular lens (IOL)-capsular bag complex. Results: We identified 132 eyes (92 patients) operated on with an MCTR. Of these eyes, 26 (20%) had suture breakage requiring re-operation, while another eight eyes (6%) had suture breakage that did not require surgery. The re-operations occurred after a mean 4.8± 3.3 years. Suture breakage occurred in patients with a mean age of 34.0± 23.3, as compared to 43.2± 26.0 years for patients who did not experience this complication (p=0.36). In patients aged 40 years or younger at the time of surgery, 47% experienced suture breakage in one or both eyes, as compared to 19% in the age group 41– 69 years and 13% in the age group 70 years and older (p=0.004). Of the 132 eyes that were operated on, we registered one case (0.8%) of possible suture-related late endophthalmitis. Conclusion: The long-term risk of suture breakage was quite high after scleral fixation of the MCTR in this patient cohort, and it seems as the risk is increased with young age.

• Sand, Mari Kathrine; Cholidis, Symira; Rimstad, Kjartan; Krekling, Elise Dees; Kristianslund, Olav & Drolsum, Liv Kari (2021). Long-term outcome of primary intraocular lens implantation in bilateral congenital cataract in infants with a median age of 35 days at surgery: A case series. BMJ Open Ophthalmology. 6:e000836, p. 1–7. doi: 10.1136/bmjophth-2021-000836. Full text in Research Archive Show summary

  Objective To evaluate the long-term visual outcome and safety after bilateral cataract surgery with primary intraocular lens (IOL) implantation in infants with visually significant cataract at birth operated before 12 weeks of age. Methods and analysis Medical records of infants with congenital cataract who had bilateral surgery with primary IOL implantation before 12 weeks of age at Oslo University Hospital between 2007 and 2016 were retrospectively reviewed. Fifteen infants (30 eyes) were enrolled for a prospective study examination in 2017. Corrected distance visual acuity (CDVA) and intraocular pressure (IOP) were assessed. Visual axis opacification (VAO) was defined as opacification on the anterior or posterior surface of the IOL, capsular phimosis or fibrinous membrane. Secondary glaucoma was evaluated according to international guidelines. Results Median age at the time of primary surgery was 35 days (range, 15 to 70 days). There were no serious intraoperative complications, and all eyes had the IOL implanted in the capsular bag. After a median follow-up of 6.1 years (range, 1.5 to 10.2 years), the CDVA was 0.5 logMAR (range, 1.2 to 0.04). All eyes had surgery for VAO and the median number of surgical procedures was 2.0 (range, 1 to 5). The cumulative incidence of secondary glaucoma was 10% after 5 years of follow-up. Conclusion Primary IOL implantation before 12 weeks of age gave a satisfactory visual outcome, and the incidence of secondary glaucoma was similar to that reported after primary IOL implantation in older infants. However, the risk of VAO was high.

• Kristianslund, Olav & Drolsum, Liv Kari (2021). Prevalence of Keratoconus in Persons with down Syndrome in a National Registry in Norway. JAMA Network Open. 4(3), p. 1–3. doi: 10.1001/jamanetworkopen.2021.0814. Full text in Research Archive Show summary

  Keratoconus is an eye condition with distinctive corneal characteristics, including thinning and a conical shape of the cornea. Keratoconus was previously considered rare; however, in recent studies, a prevalence of 0.2% to 0.3% has been reported1 and, in some studies, an even higher prevalence. An association of keratoconus with Down syndrome has been shown,2,3 although the exact reason remains unknown. In some studies, investigators have reported frequencies of keratoconus in persons with Down syndrome of 0% to 71%2-5; however, most have been limited by small sample sizes and biased patient selection. The aim of the present study was to estimate the prevalence of keratoconus among persons with Down syndrome in Norway.

• Drolsum, Liv & Kristianslund, Olav (2021). Implantation of retropupillary iris-claw lenses: A review on surgical management and outcomes. Acta Ophthalmologica. ISSN 1755-375X. 99(8), p. 826–836. doi: 10.1111/aos.14824. Full text in Research Archive Show summary

  Iris-claw lenses have gained increasing popularity over the last years and are by many surgeons regarded as viable options in eyes with insufficient capsular or zonular support. The iris-claw lens has two haptics with fine fissures for folding (enclavating) the mid-peripheral part of the iris stroma and can either be placed in front of or posterior to the iris. In particular, the retropupillary implantation has been increasingly chosen probably due to having an anatomical position similar to that of the crystalline lens. The present review is based on a literature review and also on the authors’ clinical experience with this lens, and it focuses on surgical techniques and outcomes especially related to the characteristics of this lens, having haptics with claws that fixate the lens to the posterior iris. Implanting retropupillary iris-claw lenses has a relatively short learning curve, and there are only few complications reported during surgery. Retropupillary iris-claw lenses have demonstrated generally favourable efficiency and safety. However, the outcomes are probably more influenced by the reason for surgery and eye comorbidity than the lens itself. Albeit seldom reported, the postoperative complications have mostly been related to atrophy of the iris at the site of the haptics, or IOL decentration or disenclavation of one of the haptics. To date, however, there are few randomized clinical trials comparing this lens to other lens alternatives in eyes exhibiting insufficient capsular or zonular support for placing the lens in the ciliary sulcus. In the future, prospective studies with large samples should be performed to gain insights into the long-term safety of retropupillary placed iris-claw lenses, and for comparisons with the various other techniques of lens fixation.

• Kristianslund, Olav; Dalby, Marius & Drolsum, Liv Kari (2021). Late in-the-bag intraocular lens dislocation. Journal of cataract and refractive surgery. ISSN 0886-3350. 47(7), p. 942–954. doi: 10.1097/j.jcrs.0000000000000605. Full text in Research Archive Show summary

  This review aimed to evaluate the cumulative incidence, patient characteristics, predisposing conditions, and treatment outcomes for late in-the-bag intraocular lens (IOL) dislocation. Literature searches in PubMed (MEDLINE), Embase, and Cochrane Library Central database identified 1 randomized clinical trial, 1 prospective case series, 2 prospective cohort studies, and 36 retrospective studies of this condition, which showed that the cumulative incidence was 0.5% to 3%, it occurred on average 6 to 12 years after cataract surgery, and mean patient age was 65 to 85 years. Pseudoexfoliation syndrome, myopia, and previous vitreoretinal surgery were the most common predisposing conditions. Studies indicated that IOL repositioning and IOL exchange provided similar visual outcomes and were equally safe. The long-term visual outcome seemed satisfactory. However, the quality of evidence regarding treatment was in general quite low. More studies of late in-the-bag IOL dislocation are needed, and in particular, different surgical techniques should be included in high-quality clinical trials.

• Dalby, Marius; Drolsum, Liv Kari & Kristianslund, Olav (2021). Repositioning surgery of different intraocular lens designs in eyes with late in-the-bag intraocular lens dislocation. Journal of cataract and refractive surgery. ISSN 0886-3350. 47(9), p. 1147–1152. doi: 10.1097/j.jcrs.0000000000000588. Full text in Research Archive Show summary

  Purpose: To evaluate the long-term efficacy and safety after intraocular lens (IOL) repositioning by scleral suturing of 1-piece IOL compared with other IOL designs in the treatment of late in-the-bag IOL dislocation. Setting: Patients referred to Oslo University Hospital Oslo, Norway. Design: Prospective cohort study. Methods: The study comprised 54 patients (54 eyes) with late in-the-bag IOL dislocation treated with IOL repositioning by scleral sutures (10-0 polypropylene). All operations were performed with an anterior approach and by 1 surgeon. The following IOL designs were repositioned: 1-piece foldable (n = 17), 3-piece foldable (n = 28), plate-haptic (n = 8), and 1-piece rigid (n = 1) IOLs. Patients were evaluated comprehensively preoperatively and at 6 months (80%), 1 year (67%), and 2 years (61%) postoperatively. The main outcome measures were efficacy regarding corrected distance visual acuity (CDVA) and spherical equivalent (SE) and safety regarding complications. Results: Postoperative visual acuity was similar for different IOL designs. The mean SE change to final observation was −0.08 (95% CI, −0.93 to 0.77) in the 1-piece IOL group (n = 11) and −0.98 (−1.73 to −0.23) in the 3-piece IOL group (n = 18) (P = .11). Regarding safety, no patients had uveitis–glaucoma–hyphema syndrome, retinal detachment, or endophthalmitis. The 3-piece IOL group had 1 case of redislocation and 1 case of iritis. No patients had symptoms related to clinical IOL decentration. Long-term intraocular pressure remained within normal limits with overlapping 95% CIs for different IOLs. Conclusions: Repositioning surgery of 1-piece IOLs seems as efficient and safe as that for other IOL designs in the treatment of late in-the-bag IOL dislocation.

• Kristianslund, Olav; Hagem, Anne Marie; Thorsrud, Andreas & Drolsum, Liv (2020). Prevalence and incidence of keratoconus in Norway: a nationwide register study. Acta Ophthalmologica. ISSN 1755-375X. doi: 10.1111/aos.14668. Full text in Research Archive Show summary

  Purpose To estimate the national prevalence and incidence of keratoconus in Norway. Methods In this epidemiologic study, data were obtained from the Norwegian Patient Registry, which provides information from all publicly funded specialist care in Norway. Prevalence of keratoconus was estimated from the total number of patients registered with this diagnosis and incidence from the annual frequency of first‐time registrations of patients up to 40 years of age in the period 2010–2018. Data on age and gender of the keratoconus patients were also gathered. Results A total of 9832 keratoconus patients were registered. The estimated prevalence in the general population was 192.1 per 100 000 (95% confidence interval (CI): 188.3–195.9), and the estimated annual incidence was 19.8 per 100 000 (95% CI: 18.1–21.5). There was a predominance of males (73%), and mean age for all patients was 37.5 years at first registration in this period. Conclusion This study reports the frequency of keratoconus from a national patient register during a time period with available modern diagnostic tools. The estimated prevalence and incidence were higher than most previous estimates and show that keratoconus is not a rare condition. As screening was not part of the study, the true prevalence in the general population may be even higher.

• Kvernebo, Anne Kari; Miyamoto, Takuma; Sporastøyl, Ane Halse; Sundheim, Liv Kristin Ribbskog; Måsøy, Svein-Erik & Drolsum, Liv [Show all 10 contributors for this article] (2020). Quantification of ocular surface microcirculation by computer assisted video microscopy and diffuse reflectance spectroscopy. Experimental Eye Research. ISSN 0014-4835. 201, p. 1–7. doi: 10.1016/j.exer.2020.108312. Full text in Research Archive Show summary

  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.

• Kristianslund, Olav; Dalby, Marius & Drolsum, Liv (2020). Dislokasjon av kunstig linse. Tidsskrift for Den norske legeforening (Tidsskriftet). ISSN 0029-2001. 7. doi: 10.4045/tidsskr.19.0526. Full text in Research Archive
• Dalby, Marius; Kristianslund, Olav; Østern, Atle Einar; Falk, Ragnhild Sørum & Drolsum, Liv (2020). Longitudinal corneal endothelial cell loss after corrective surgery for late in-the-bag IOL dislocation: a randomized clinical trial. Journal of cataract and refractive surgery. ISSN 0886-3350. 46(7), p. 1030–1036. doi: 10.1097/j.jcrs.0000000000000213. Full text in Research Archive Show summary

  Purpose: To compare safety regarding longitudinal corneal endothelial cell loss (ECL) after IOL exchange vs IOL repositioning for late in-the-bag IOL dislocation. Setting: Oslo University Hospital, Norway. Design: Prospective, parallel group, randomized clinical trial. Methods: During a 3-year period, 104 patients were randomly assigned to groups receiving either IOL exchange with retropupillary fixation of an iris-claw IOL (n = 50) or IOL repositioning by scleral suturing (n = 54). All operations were performed by 1 surgeon with an anterior approach. Endothelial cell density (ECD) and central corneal thickness were measured preoperatively and at 6 months, 1 year, and 2 years postoperatively. A linear mixed model was applied for the longitudinal analysis, where patients with at least 1 ECD measurement were included (n = 44 exchange; n = 50 repositioning). The main outcome measure was 2-year longitudinal ECL in IOL exchange compared with IOL repositioning. Results: The longitudinal ECL was similar between the IOL exchange (n = 44) and IOL repositioning (n = 50) groups during the 2 years of follow-up (17.5% vs 15.3%, P = .15). A subgroup analysis found no reason to advise against either method for patients with low preoperative ECD (<1500 cells/mm2). The mean central corneal thickness was similar between the 2 groups and remained stable over 2 years of follow-up. Conclusions: This randomized clinical trial of late in-the-bag IOL dislocation surgery found that exchanging the IOL was as safe as repositioning in terms of 2-year longitudinal ECL.

• Bisevac, Jovana; Anisimova, Natalia S.; Nagymihaly, Richard; Kristianslund, Olav; Katta, Kirankumar & Noer, Agate [Show all 11 contributors for this article] (2020). Long-term myofibroblast persistence in the capsular bag contributes to the late spontaneous in-the-bag intraocular lens dislocation. Scientific Reports. 10, p. 1–17. doi: 10.1038/s41598-020-77207-7. Full text in Research Archive Show summary

  Abstract Late spontaneous in-the-bag intraocular lens (IOL) dislocation is a complication presenting 6 months or later after cataract surgery. We aimed to characterize the cells in the lens capsules (LCs) of 18 patients with spontaneous late in-the-bag IOL dislocation. Patients' average age was 82.6 ± 1.5 years (range 72–98), and most of them had pseudoexfoliation syndrome (PEX). Cells from the LCs were positive for myofibroblast (αSMA), proliferation (Ki-67, PCNA), early lens development/lens progenitor (SOX2, PAX6), chemokine receptor (CXCR4), and transmembrane (N-cadherin) markers, while negative for epithelial (E-cadherin) marker. Moreover, the cells produced abundant fibronectin, type I and type V collagen in the nearby extracellular matrix (ECM). During ex vivo cultivation of dislocated IOL-LCs in toto, the cells proliferated and likely migrated onto the IOL’s anterior side. EdU proliferation assay confirmed the proliferation potential of the myofibroblasts (MFBs) in dislocated IOL-LCs. Primary cultured lens epithelial cells/MFBs isolated from the LC of dislocated IOLs could induce collagen matrix contraction and continuously proliferated, migrated, and induced ECM remodeling. Taken together, this indicates that long-lived MFBs of dislocated IOLs might contribute to the pathogenic mechanisms in late in-the-bag IOL dislocation.

• Vanem, Thy Thy; Böker, Tordis; Sandvik, Gunhild Falleth; Kirkhus, Eva Astrid; Smith, Hans-Jørgen & Andersen, Kai [Show all 13 contributors for this article] (2019). Marfan syndrome: Evolving organ manifestations-A 10-year follow-up study. American Journal of Medical Genetics. Part A. ISSN 1552-4825. 182(2), p. 397–408. doi: 10.1002/ajmg.a.61441. Full text in Research Archive Show summary

  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.

• Kristianslund, Olav; Pathak, Meeta; Østern, Atle Einar & Drolsum, Liv (2019). Corneal endothelial cell loss following cataract surgery in patients with pseudoexfoliation syndrome: a 2‐year prospective comparative study. Acta Ophthalmologica. ISSN 1755-375X. doi: 10.1111/aos.14314. Full text in Research Archive
• Dalby, Marius; Kristianslund, Olav & Drolsum, Liv (2019). Long-Term Outcomes after Surgery for Late In-The-Bag Intraocular Lens Dislocation: A Randomized Clinical Trial. American Journal of Ophthalmology. ISSN 0002-9394. 207, p. 184–194. doi: 10.1016/j.ajo.2019.05.030. Full text in Research Archive Show summary

  Purpose To compare the long-term efficacy and safety of 2 operation methods for late in-the-bag intraocular lens (IOL) dislocation. Design Prospective, randomized, parallel group surgical clinical trial. Methods During a 3-year period, 104 patients (104 eyes) were assigned one group for IOL repositioning by scleral suturing (n = 54) or one group for IOL exchange by retropupillary fixation of an iris claw IOL (n = 50). A single surgeon performed all operations using an anterior approach. Patients were examined before surgery and at 6 months and 1 and 2 years after surgery. The present study included the 66 patients (63%) who completed the 2-year follow-up, and the main outcaome measurement was corrected distance visual acuity (CDVA) 2 years after surgery. Results After 2 years, the mean CDVA was 0.20 ± 0.29 logarithm of the minimum angle of resolution (logMAR) units (range, −0.18 to 1.10) in the repositioning group and 0.22 ± 0.30 logMAR (range, −0.10 to 1.22) in the exchange group (P = .69). A CDVA of 20/40 or better was achieved by 76% of all patients. Four eyes (12%) had cystoid macular edema in the repositioning group compared with 5 eyes (15%) in the exchange group. Two eyes underwent redislocation (1 in each group). There were no cases of endophthalmitis or retinal detachment. Conclusions There were no significant differences between the visual acuity using IOL repositioning and that using IOL exchange 2 years after surgery. The two methods were equally efficient and safe from a long-term perspective and are both considered acceptable treatments.

• Kristianslund, Olav; Dalby, Marius; Moe, Morten Carsten & Drolsum, Liv (2019). Cost-effectiveness analysis in a randomized trial of late in-the-bag intraocular lens dislocation surgery: repositioning versus exchange. Acta Ophthalmologica. ISSN 1755-375X. 97(8), p. 1–7. doi: 10.1111/aos.14108. Full text in Research Archive Show summary

  Purpose To compare the cost‐effectiveness of two operation methods for late in‐the‐bag intraocular lens (IOL ) dislocation. Methods In this randomized clinical trial, 104 patients were randomly assigned to IOL repositioning by scleral suturing (n = 54) or IOL exchange with a retropupillary iris‐claw lens (n = 50). A cost‐effectiveness analysis (CEA ) was performed in conjunction with previously published 6‐month efficacy and safety results. An incremental cost‐effectiveness ratio was calculated as the cost difference between the operation groups relative to their difference in postoperative corrected distance visual acuity (CDVA ) (mean and 95% confidence interval: minimum and maximum), reported as the cost difference in United States Dollars ($) per logMAR difference. Results Exchange surgery was $281.20 ± 17.66 more expensive than repositioning, mainly explained by the new IOL and the frequent use of anterior vitrectomy. A previous trial publication revealed no significant difference in the 6‐month postoperative CDVA between the groups. In the CEA , the mean group difference yielded an incremental cost‐effectiveness ratio of −$281.20 per −0.11 logMAR (‐$1108/QALY ) in favour of repositioning, ranging from −$281.20 per −0.29 logMAR (‐$406/QALY ) in favour of repositioning to +$281.20 per −0.08 logMAR (+$1522/QALY ) in favour of exchange. The CEA did not include the mean 9.5 min shorter operation time for exchange. Conclusion Repositioning tended to be more cost‐effective than exchange; however, this is modified if also considering the operation time. Overall, it seems the cost‐effectiveness is not alone sufficiently different to recommend one of the operation methods over the other for late in‐the‐bag IOL dislocation.

• Benavent, Sigrid Aune de Rodez; Nygaard, Gro Owren; Nilsen, Kristian Bernhard; Etholm, Lars; Sowa, Piotr & Gustavsen, Marte Wendel [Show all 11 contributors for this article] (2019). Neurodegenerative interplay of cardiovascular autonomic dysregulation and the retina in early multiple sclerosis. Frontiers in Neurology. 10, p. 1–9. doi: 10.3389/fneur.2019.00507. Full text in Research Archive Show summary

  Introduction: Autonomic nervous system (ANS) symptoms are prevalent in multiple sclerosis (MS) as is neurodegeneration. Our aim was to explore the occurrence of ANS symptoms and retinal neurodegeneration in a newly diagnosed MS population with tools available in a clinical setting. Methods: Forty-three MS patients and 44 healthy controls took part in the study. We employed a bedside cardiovascular ANS test battery together with classical pupillometry, optical coherence tomography (OCT) evaluation of retinal neurodegeneration in eyes without previous optic neuritis (MSNON) and patients' self-report forms on fatigue, orthostatic and ANS symptoms. Results: Half of the patients presented with ANS symptoms and a high level of fatigue. There was a significant difference in ganglion cell layer thickness (mean GCIPL) evaluated by OCT in MSNON compared to healthy control eyes. We found a negative linearity of mean GCIPL on group level with increasing disease duration. Three patients fulfilled the criteria of postural orthostatic tachycardia syndrome (POTS). Conclusion: Our results demonstrate retinal neurodegeneration in MSNON, a high frequency of fatigue and a high prevalence of ANS symptoms in newly diagnosed patients. Whether neurodegeneration precedes ANS dysfunction or vice versa is still open to debate, but as unveiled by the presence of POTS in this MS population, differences in stress-response regulation add to the understanding of variation in onset-time of ANS dysfunction in early MS.

• Hagem, Anne Marie; Thorsrud, Andreas; Sandvik, Gunhild Falleth & Drolsum, Liv (2019). Randomized study of collagen cross-linking with conventional versus accelerated UVA irradiation using riboflavin with hydroxypropyl methylcellulose: Two-year results. Cornea. ISSN 0277-3740. 38(2), p. 203–209. doi: 10.1097/ICO.0000000000001791. Full text in Research Archive
• Sæthre, Marit; Krekling, Elise Dees & Drolsum, Liv (2019). Lower risk of graft dislocation applying organ cultured corneas compared with cold short-term cultured corneas during DSAEK surgery. Eye (London. 1987). ISSN 0950-222X. p. 1–6. doi: 10.1038/s41433-019-0579-8. Full text in Research Archive
• Kristianslund, Olav; Dalby, Marius & Drolsum, Liv (2019). High intraocular pressure in eyes with late in-the-bag intraocular lens dislocation. Journal of cataract and refractive surgery. ISSN 0886-3350. 45(7), p. 1043–1044. doi: 10.1016/j.jcrs.2019.02.042. Full text in Research Archive Show summary

  The frequency of late in-the-bag intraocular lens (IOL) dislocation has increased over the past decades. Important predisposing factors are pseudoexfoliation syndrome (PXF), myopia, previous vitreoretinal surgery, and trauma,1–3 and there is also an association with glaucoma.1–4 Furthermore, some studies report high intraocular pressure (IOP) in eyes with IOL dislocation despite no known glaucoma.1–5 Accordingly, it has been speculated whether the dislocation can cause an IOP increase. In a recent study addressing the association between high IOP and spontaneous in-the-bag IOL dislocation, Lorente Bulnes et al.6 found a significant trend toward higher IOP when a lower grade of dislocation was diagnosed. They suggested that movement of the loosened IOL in mild dislocation might cause iris chafing. The aim of the present analysis was to evaluate the possible association between the IOP at diagnosis and the grade of IOL dislocation in a large clinical trial.

• Råen, Marianne; Kristianslund, Olav; Østern, Atle Einar; Sandvik, Gunhild Falleth & Drolsum, Liv (2019). Are Elderly Patients Optimally Corrected with Spectacles in the Longer Term after Cataract Surgery? Optometry and Vision Science. ISSN 1040-5488. 96(5), p. 362–366. doi: 10.1097/OPX.0000000000001371. Full text in Research Archive
• Pathak, Meeta; Diep, Phoi Phoi; Lai, Xiaoran; Brinch, Lorentz; Ruud, Ellen & Drolsum, Liv (2018). Ocular findings and ocular graft-versus-host disease after allogeneic stem cell transplantation without total body irradiation. Bone Marrow Transplantation. ISSN 0268-3369. 53, p. 863–872. doi: 10.1038/s41409-018-0090-z. Full text in Research Archive Show summary

  Patients treated with allogeneic stem cell transplantation (allo-SCT) often develop ocular complications. To investigate the ocular findings in young long-term survivors after allo-SCT without TBI, we examined 96 patients more than 5 years after transplantation. All patients were under 30 years of age at transplantation. The mean follow-up time was 16.8 years (range 6.0–26.1 years). The study was a part of the Norwegian Allo Survivorship Study investigating health impairments in young survivors after allo-SCT. Ophthalmological examination included visual acuity, tear break-up time, corneal fluorescein staining, Schirmer I test, tear film osmolarity, biomicroscopy and dilated ophthalmoscopy. In patients with known systemic chronic GVHD (cGVHD), ocular GVHD (oGVHD) diagnosed by clinical examination was compared with diagnosis using National Institutes of Health (NIH) or International Chronic Ocular Graft-vs-Host-Disease (ICCGVHD) Consensus Group criteria. We diagnosed dry eye disease (DED) in 52 patients (54%), cataract in 3 patients (3%) and retinopathy in 1 patient (1%). Systemic cGVHD was a risk factor for DED (OR 4.40, CI 1.33–14.56, p = 0.02). Comparison of diagnostic criteria suggests that the more stringent ICCGVHD criteria can better differentiate DED from oGVHD after allo-SCT as compared with the NIH criteria.

• Thorsrud, Andreas; HAGEM, ANNE MARIE; Sandvik, Gunhild Falleth & Drolsum, Liv (2018). Superior outcome of corneal collagen cross-linking using riboflavin with methylcellulose than riboflavin with dextran as the main supplement. Acta Ophthalmologica. ISSN 1755-375X. doi: 10.1111/aos.13928. Full text in Research Archive
• Riise, Nina; Lindberg, Bjørn; Kulseth, Mari Ann; Fredwall, Svein Otto; Lundby, Rigmor & Estensen, Mette-Lise [Show all 10 contributors for this article] (2018). Clinical diagnosis of Larsen syndrome, Stickler syndrome and Loeys-Dietz syndrome in a 19-year old male: a case report. BMC Medical Genetics. 19(155), p. 1–7. doi: 10.1186/s12881-018-0671-0. Full text in Research Archive Show summary

  Background Larsen syndrome is a hereditary disorder characterized by osteochondrodysplasia, congenital large-joint dislocations, and craniofacial abnormalities. The autosomal dominant type is caused by mutations in the gene that encodes the connective tissue protein, filamin B (FLNB). Loeys-Dietz syndrome (LDS) is an autosomal dominant connective tissue disorder characterized by arterial aneurysms, dissections and tortuosity, and skeletal, including craniofacial, manifestations. Mutations in five genes involved in the transforming growth factor beta (TGF-β) signaling pathway cause five types of LDS. Stickler syndrome is a genetically heterogeneous arthro-ophthalmopathy caused by defects in collagen, exhibiting a wide specter of manifestations in connective tissue. A rare case is reported that was diagnosed with all these three hereditary connective tissue disorders. Case presentation A 19 year-old, Norwegian male with a clinical diagnosis of Larsen syndrome and with healthy, non-consanguineous parents attended a reference center for rare connective tissue disorders. Findings at birth were hypotonia, joint hypermobility, hyperextended knees, adductovarus of the feet, cervical kyphosis, craniofacial abnormalities, and an umbilical hernia. From toddlerhood, he required a hearing aid due to combined conductive and sensorineural hearing loss. Eye examination revealed hyperopia, astigmatism, and exotropia. At 10 years of age, he underwent emergency surgery for rupture of an ascending aortic aneurysm. At 19 years of age, a diagnostic re-evaluation was prompted by the findings of more distal aortic dilation, tortuosity of precerebral arteries, and skeletal findings. High throughput sequencing of 34 genes for hereditary connective tissue disorders did not identify any mutation in FLNB, but did identify a de novo missense mutation in TGFBR2 and a nonsense mutation in COL2A1 that was also present in his unaffected father. The diagnosis was revised to LDS Type 2. The patient also fulfills the proposed criteria for Stickler syndrome with bifid uvula, hearing loss, and a known mutation in COL2A1. Conclusion LDS should be considered in patients with a clinical diagnosis of Larsen syndrome, in particular in the presence of arterial aneurysms or tortuosity. Due to genetic heterogeneity and extensive overlap of clinical manifestations, genetic high throughput sequencing analysis is particularly useful for the differential diagnosis of hereditary connective tissue disorders.

• Sandvik, Gunhild Falleth; Vanem, Thy Thy; Rand-Hendriksen, Svend; Cholidis, Symira; Sæthre, Marit & Drolsum, Liv (2018). Ten-year reinvestigation of ocular manifestations in Marfan syndrome. Clinical and Experimental Ophthalmology (CEO). ISSN 1442-6404. p. 1–7. doi: 10.1111/ceo.13408. Full text in Research Archive Show summary

  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.

• Thorsrud, Andreas; Sandvik, Gunhild Falleth; HAGEM, ANNE MARIE & Drolsum, Liv (2017). Measuring the depth of crosslinking demarcation line in vivo: Comparison of methods and devices. Journal of cataract and refractive surgery. ISSN 0886-3350. 43(2), p. 255–262. doi: 10.1016/j.jcrs.2017.01.003. Full text in Research Archive
• Benavent, Sigrid Aune de Rodez; Nygaard, Gro Owren; Harbo, Hanne Flinstad; Tønnesen, Siren; Sowa, Piotr & Landrø, Nils Inge [Show all 13 contributors for this article] (2017). Fatigue and cognition: Pupillary responses to problem-solving in early multiple sclerosis patients. Brain and Behavior. 7(7). doi: 10.1002/brb3.717. Full text in Research Archive Show summary

  Introduction In early multiple sclerosis (MS) patients, cognitive changes and fatigue are frequent and troublesome symptoms, probably related to both structural and functional brain changes. Whether there is a common cause of these symptoms in MS is unknown. In theory, an altered regulation of central neuropeptides can lead to changes in regulation of autonomic function, cognitive difficulties, and fatigue. Direct measurements of central neuropeptides are difficult to perform, but measurements of the eye pupil can be used as a reliable proxy of function. Methods This study assesses pupil size during problem-solving in early MS patients versus controls. A difference in pupil size to a cognitive challenge could signal altered activity within the autonomic system because of early functional brain changes associated with cognitive load. We recruited MS patients (mean disease duration: 2.6 years, N = 41) and age-matched healthy controls (N = 43) without eye pathology. Neurological impairment, magnetic resonance imaging, visual evoked potentials, depression, and fatigue were assessed in all of the patients. In both groups, we assessed processing speed and retinal imaging. Pupil size was recorded with an eye-tracker during playback of multiplication tasks. Results Both groups performed well on the cognitive test. The groups showed similar pupillary responses with a mean of 0.55 mm dilation in patients and 0.54 mm dilation in controls for all the tasks collapsed together. However, controls (N = 9) with low cognitive scores (LCS) had an increased pupillary response to cognitive tasks, whereas LCS MS patients (N = 6) did not (p < .05). There was a tendency toward a smaller pupillary response in patients with fatigue. Conclusions This is the first study to investigate pupillary responses to cognitive tasks in MS patients. Our results suggest that MS-related changes in cognition and fatigue may be associated with changes in arousal and the autonomic regulation of task-related pupillary responses. This supports the theory of a link between cognition and fatigue in MS.

• Johannsdottir, Inga Marie; Hamre, Hanne Mari; Fosså, Sophie Dorothea; Loge, Jon Håvard; Drolsum, Liv & Lund, May-Brith [Show all 8 contributors for this article] (2017). Adverse Health Outcomes and Associations with Self-Reported General Health in Childhood Lymphoma Survivors. Journal of Adolescent and Young Adult Oncology. ISSN 2156-5333. 6(3), p. 470–476. doi: 10.1089/jayao.2017.0018. Full text in Research Archive
• Hagem, Anne Marie; Thorsrud, Andreas; Sandvik, Gunhild Falleth; Råen, Marianne & Drolsum, Liv (2017). Collagen crosslinking with conventional and accelerated ultraviolet-A irradiation using riboflavin with hydroxypropyl methylcellulose. Journal of cataract and refractive surgery. ISSN 0886-3350. 43(4), p. 511–517. doi: 10.1016/j.jcrs.2017.01.013. Full text in Research Archive
• Kristianslund, Olav; Råen, Marianne; Østern, Atle Einar & Drolsum, Liv (2017). Late In-the-Bag Intraocular Lens Dislocation: A Randomized Trial Comparing Lens Repositioning and Lens Exchange. Ophthalmology (Rochester, Minn.). ISSN 0161-6420. 124(2), p. 151–159. doi: 10.1016/j.ophtha.2016.10.024. Full text in Research Archive Show summary

  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.

• Kristianslund, Olav; Råen, Marianne; Østern, Atle Einar & Drolsum, Liv (2017). Glaucoma and Intraocular Pressure in Patients Operated for Late In-the-bag Intraocular Lens Dislocation: A Randomized Clinical Trial. American Journal of Ophthalmology. ISSN 0002-9394. 176, p. 219–227. doi: 10.1016/j.ajo.2017.01.026. Full text in Research Archive
• Kristianslund, Olav; Østern, Atle Einar & Drolsum, Liv (2017). Astigmatism and Refractive Outcome After Late In-The-Bag Intraocular Lens Dislocation Surgery: A Randomized Clinical Trial. Investigative Ophthalmology and Visual Science. ISSN 0146-0404. 58(11), p. 4747–4753. doi: 10.1167/iovs.17-22723. Full text in Research Archive Show summary

  Purpose: To compare surgically induced astigmatism (SIA) and refractive outcomes between two operation methods for late in-the-bag IOL dislocation. Methods: In this prospective, randomized, parallel-group clinical trial, 104 patients (eyes) were assigned to IOL repositioning by scleral suturing 1.5- to 2-mm posterior to limbus (n = 54) or IOL exchange with a retropupillar iris-claw IOL using a 5.5-mm scleral pocket incision (n = 50). The SIA was determined by vector analysis through conversion of corneal cylinders to Cartesian coordinates, and is presented as magnitude in diopters @ direction in degrees (D @ °). Follow-up was 6 months. Results: The SIA was 0.24 D @ 8° for IOL repositioning and 0.65 D @ 171° for IOL exchange, which was a nonsignificant group difference (X coordinate: P = 0.08; Y coordinate: P = 0.16). Mean SIA magnitude was 0.60 ± 0.50 D and 1.12 ± 0.85 D, respectively (P < 0.001). Mean postoperative spherical equivalent was −1.6 ± 1.6 D after IOL repositioning and −0.5 ± 1.0 D after IOL exchange (P < 0.001). For IOL repositioning, this represented a mean myopic shift of −0.7 ± 1.1 D compared with before the IOL dislocation (P < 0.001). For IOL exchange, it was within ±1 D of target refraction in 83% of the patients. Conclusions: Surgically induced astigmatism was modest in both operation groups, albeit with a tendency of being more pronounced for IOL exchange. Repositioning surgery led to a myopic shift, whereas exchange surgery provided good refractive predictability.

• Pathak, Meeta; Olstad, Ole Kristoffer; Drolsum, Liv; Moe, Morten Carsten; Smorodinova, Natalia & Kalasova, Sarka [Show all 9 contributors for this article] (2016). The effect of culture medium and carrier on explant culture of human limbal epithelium: A comparison of ultrastructure, keratin profile and gene expression. Experimental Eye Research. ISSN 0014-4835. 153, p. 122–132. doi: 10.1016/j.exer.2016.09.012. Full text in Research Archive
• Kristianslund, Olav; Østern, Atle Einar; Råen, Marianne; Sandvik, Gunhild & Drolsum, Liv (2016). Does cataract surgery reduce the long-term risk of glaucoma in eyes with pseudoexfoliation syndrome? Acta Ophthalmologica. ISSN 1755-375X. 94(3), p. 261–265. doi: 10.1111/aos.12945. Full text in Research Archive
• Nygaard, Gro Owren; Benavent, Sigrid Aune de Rodez; Harbo, Hanne Flinstad; Laeng, Bruno; Sowa, Piotr & Damangir, Soheil [Show all 13 contributors for this article] (2015). Eye and hand motor interactions with the Symbol Digit Modalities Test in early multiple sclerosis. Multiple Sclerosis and Related Disorders. ISSN 2211-0348. 4(6), p. 585–589. doi: 10.1016/j.msard.2015.08.003. Full text in Research Archive Show summary

  Purpose Eye and hand motor dysfunction may be present early in the disease course of relapsing-remitting multiple sclerosis (RRMS), and can affect the results on visual and written cognitive tests. We aimed to test for differences in saccadic initiation time (SI time) between RRMS patients and healthy controls, and whether SI time and hand motor speed interacted with the written version of the Symbol Digit Modalities Test (wSDMT). Methods Patients with RRMS (N=44, age 35.1±7.3 years), time since diagnosis <3 years and matched controls (N=41, age 33.2±6.8 years) were examined with ophthalmological, neurological and neuropsychological tests, as well as structural MRI (white matter lesion load (WMLL) and brainstem lesions), visual evoked potentials (VEP) and eye-tracker examinations of saccades. Results SI time was longer in RRMS than controls (p<0.05). SI time was not related to the Paced Auditory Serial Addition Test (PASAT), WMLL or to the presence of brainstem lesions. 9 hole peg test (9HP) correlated significantly with WMLL (r=0.58, p<0.01). Both SI time and 9HP correlated negatively with the results of wSDMT (r=−0.32, p<0.05, r=−0.47, p<0.01), but none correlated with the results of PASAT. Conclusions RRMS patients have an increased SI time compared to controls. Cognitive tests results, exemplified by the wSDMT, may be confounded by eye and hand motor function.

• Sandvik, Gunhild; Thorsrud, Andreas; Råen, Marianne; Østern, Atle Einar; Sæthre, Marit & Drolsum, Liv (2015). Does Corneal Collagen Cross-linking Reduce the Need for Keratoplasties in Patients with Keratoconus? Cornea. ISSN 0277-3740. 34(9), p. 991–995. doi: 10.1097/ICO.0000000000000460. Full text in Research Archive
• Drolsum, Liv; Rand-Hendriksen, Svend; Paus, Benedicte; Geiran, Odd & Semb, Svein Ove (2015). Ocular findings in 87 adults with Ghent-1 verified Marfan syndrome. Acta Ophthalmologica. ISSN 1755-375X. 93(1), p. 46–53. doi: 10.1111/aos.12448. Full text in Research Archive Show summary

  Purpose To study ocular characteristics in 87 patients with verified Marfan syndrome (MFS) based on the Ghent criteria from 1996 (Ghent-1). Methods The position of the lens was noted by observing the eye in different gaze directions in maximal mydriasis during slit lamp examination. Ectopia lentis (EL) was classified as subluxated (dislocation slightly backwards) or luxated (vertical or horizontal displacement). Corneal curvature, axial length (AL), corneal diameter, central corneal thickness, anterior chamber depth, lens thickness, condition of the iris, intraocular pressure, spherical equivalent and visual acuity were also investigated. Results EL was found in 108 eyes (62.1%). Of the 68 phakic eyes with EL, 43 (63.2%) had subluxation. Mean AL was 24.80 ± 2.57 mm, and the AL was above 23.5 mm in 65.3%. Mean keratometry (K) in phakic eyes was 41.79 ± 1.70 diopters (D), and the K value was <41.5D in 46.8%. Iris hypoplasia was found in 3.4%. Myopia above 3D occurred in 38.4% of the phakic eyes. Mean binocular logMAR was 0.10 ± 0.32. Only five patients (5.7%) had a logMAR more than 0.5. These 5 patients had EL, and 4 of them were amblyopic. Conclusion In this strictly defined MFS group fulfilling the Ghent-1 criteria, the prevalence of EL was 62.1%. In many cases, the dislocation of the lens was subtle. On average, the corneas were flattened and the globe length was increased. Only a few patients were visually impaired. Children with MFS should have a thorough follow up to avoid amblyopia.

• Østern, Atle Einar; Sandvik, Gunhild & Drolsum, Liv (2014). Positioning of the posterior intraocular lens in the longer term following cataract surgery in eyes with and without pseudoexfoliation syndrome. Acta Ophthalmologica Scandinavica. ISSN 1395-3907. 92(3), p. 253–258. doi: 10.1111/aos.12025. Full text in Research Archive
• Sæthre, Marit & Drolsum, Liv (2014). The role of postoperative positioning after DSAEK in preventing graft dislocation. Acta Ophthalmologica. ISSN 1755-375X. 92(1), p. 77–81. doi: 10.1111/j.1755-3768.2012.02560.x. Full text in Research Archive
• Østern, Atle Einar; Sandvik, Gunhild & Drolsum, Liv (2014). Late-in-the-bag intraocular lens dislocation in eyes with pseudoexfoliation syndrome. Acta Ophthalmologica. ISSN 1755-375X. 92(2), p. 184–191. doi: 10.1111/aos.12024. Full text in Research Archive
• Haug, Kristiane; Azqueta, Oscoz Amaya; Johnsen-Soriano, Siv; Shahdafar, Aboulghassem; Drolsum, Liv & Moe, Morten Carsten [Show all 10 contributors for this article] (2013). Donor cornea transfer from Optisol GS to organ culture storage: a two-step procedure to increase donor tissue lifespan. Acta Ophthalmologica. ISSN 1755-375X. 91(3), p. 219–225. doi: 10.1111/j.1755-3768.2012.02390.x. Full text in Research Archive Show summary

  Purpose:  Storage time for donor corneas in Optisol GS is limited compared to Eye Bank Organ Culture (EBOC). We here examine the epithelium on donor corneoscleral rims after primary storage in Optisol GS and subsequent incubation in EBOC. Methods:  Morphology was monitored by light and electron microscopy, expression of phenotypic and genotypic markers by immunohistochemistry and RT-PCR and changes in oxidative lipid and DNA damage by ELISA and COMET assay. Results:  A prominent loss of cells was observed after storage in Optisol GS. After maintenance in EBOC, spreading apical cells were Occludin+, while the staining for E-cadherin and Connexin-43 was less intense. There were an upregulation of Occludin and a downregulation of E-cadherin and Connexin-43. Eye Bank Organ Culture was associated with an ongoing proliferative activity and a downregulation of putative progenitor/stem cell marker ABCG2 and p63. Staining for 8-OHdG and Caspase-3 did not increase, while levels of malondialdehyde and number of DNA strand breaks and oxidized bases increased. Conclusions:  This dual procedure should be pursued as an option to increase the storage time and the pool of available donor corneas. The observed downregulation of markers associated with stemness during EBOC is relevant considering the potential use of donor epithelium in the treatment of ocular surface disorders. Re-use of this article is permitted in accordance with the Terms and Conditions set out at http://wileyonlinelibrary.com/onlineopen#\OnlineOpen_Terms

• Lorenzo, Yolanda; Haug, Kristiane; Ustgaard-Andersen, Kristine; Johnsen, Erik Otter; Ringvold, Amund & Moe, Morten Carsten [Show all 10 contributors for this article] (2013). Trypsin for Dissociation of Limbal Cells for Engineering of Grafts May Induce DNA Strand Breaks in the Harvested Cells. Journal of Ocular Biology. ISSN 2334-2838. 11, p. 1–6. Full text in Research Archive
• Østern, Atle Einar; Sæthre, Marit; Sandvik, Gunhild; Råen, Marianne & Drolsum, Liv (2013). Posterior capsular opacification in patients with pseudoexfoliation syndrome: a long-term perspective. Acta Ophthalmologica. ISSN 1755-375X. 91(3), p. 231–235. doi: 10.1111/j.1755-3768.2011.02380.x. Full text in Research Archive
• Råen, Marianne; Sandvik, Gunhild & Drolsum, Liv (2013). Endophthalmitis following cataract surgery: the role of prophylactic postoperative chloramphenicol eye drops. Acta Ophthalmologica. ISSN 1755-375X. 91(2), p. 118–122. doi: 10.1111/j.1755-3768.2011.02324.x. Full text in Research Archive
• Pathak, Meeta; Cholidis, Symira; Haug, Kristiane; Shahdafar, Aboulghassem; Moe, Morten Carsten & Nicolaissen, Bjørn [Show all 7 contributors for this article] (2012). Clinical transplantation of ex vivo expanded autologous limbal epithelial cells using a culture medium with human serum as single supplement: a retrospective case series. Acta Ophthalmologica. ISSN 1755-375X. doi: 10.1111/j.1755-3768.2012.02521.x. Full text in Research Archive
• Shahdafar, Aboulghassem; Haug, Kristiane; Pathak, Meeta; Drolsum, Liv; Olstad, Ole Kristoffer & Johnsen, Erik Otter [Show all 9 contributors for this article] (2012). Ex vivo expanded autologous limbal epithelial cells on amniotic membrane using a culture medium with human serum as single supplement. Experimental Eye Research. ISSN 0014-4835. 97(1), p. 1–9. doi: 10.1016/j.exer.2012.01.013. Full text in Research Archive
• Østern, Atle Einar; Sandvik, Gunhild & Drolsum, Liv (2012). Late in-the-bag intraocular lens dislocation in eyes with pseudoexfoliation syndrome. Acta Ophthalmologica Scandinavica. ISSN 1395-3907. doi: 10.1111/aos.12024. Full text in Research Archive
• Thorsrud, Andreas; Nicolaissen, Bjørn & Drolsum, Liv (2012). Corneal collagen crosslinking in vitro: Inhibited regeneration of human limbal epithelial cells after riboflavin-ultraviolet-A exposure. Journal of cataract and refractive surgery. ISSN 0886-3350. 38(6), p. 1072–1076. doi: 10.1016/j.jcrs.2011.12.038. Full text in Research Archive
• Macpherson, James; Slettedal, Jon Klokk; Drolsum, Liv & Thilesen, Trond (2012). Spontaneous hemorrhagic Descemet membrane detachment causing pupillary block. European Journal of Ophthalmology. ISSN 1120-6721. 22(5), p. 819–822. doi: 10.5301/ejo.5000164. Full text in Research Archive
• Østern, Atle Einar & Drolsum, Liv (2012). Corneal endothelial cells 6-7 years following cataract surgery in patients with pseudoexfoliation syndrome. Acta Ophthalmologica. ISSN 1755-375X. 90(5), p. 408–411. doi: 10.1111/j.1755-3768.2010.02012.x. Full text in Research Archive
• Bakke, Espen; Stojanovic, Aleksandar; Chen, X & Drolsum, Liv (2009). Penetration of riboflavin and postoperative pain in corneal collagen crosslinking Excimer laser superficial versus mechanical full-thickness epithelial removal. Journal of cataract and refractive surgery. ISSN 0886-3350. 35(8), p. 1363–1366. doi: 10.1016/j.jcrs.2009.03.023. Full text in Research Archive
• Slettedal, Jon Klokk; Drolsum, Liv; Ramstad, H & Nicolaissen, Bjørn (2008). Eye banks and available transplants. Tidsskrift for Den norske legeforening (Tidsskriftet). ISSN 0029-2001. 128(8), p. 929–932. Full text in Research Archive
• Drolsum, Liv; Ringvold, Amund & Nicolaissen, Bjørn (2007). Cataract and glaucoma surgery in pseudoexfoliation syndrome: a review. Acta Ophthalmologica Scandinavica. ISSN 1395-3907. 85(8), p. 810–21. Full text in Research Archive
• Drolsum, Liv (2007). The role of non-penetrating filtering procedures in glaucoma surgery. Acta Ophthalmologica Scandinavica. ISSN 1395-3907. 85(2), p. 124–6. Full text in Research Archive
• Drolsum, Liv & Haughom, Bente (2007). Deficiency of cornea transplant donors. Tidsskrift for Den norske legeforening (Tidsskriftet). ISSN 0029-2001. 127(24), p. 3238–9. Full text in Research Archive
• Ræder, Sten; Utheim, Tor Paaske; Utheim, Øygunn; Nicolaissen, Bjørn; Roald, Borghild Barth-H & Cai, Yiqing [Show all 12 contributors for this article] (2007). Effects of organ culture and Optisol-GS storage on structural integrity, phenotypes, and apoptosis in cultured corneal epithelium. Investigative Ophthalmology and Visual Science. ISSN 0146-0404. 48(12), p. 5484–5493. doi: 10.1167/iovs.07-0494. Full text in Research Archive
• Utheim, Tor Paaske; Ræder, Sten; Kristiansen, Øygunn Aass; Cai, Yiqing; Roald, Borghild Barth-H & Drolsum, Liv [Show all 8 contributors for this article] (2007). A novel method for preserving cultured limbal epithelial cells. British Journal of Ophthalmology. ISSN 0007-1161. 91. Full text in Research Archive
• Drolsum, Liv (2006). Longterm follow-up after deep sclerectomy in patients with pseudoexfoliate glaucoma. Acta Ophthalmologica Scandinavica. ISSN 1395-3907. 84(4), p. 502–506. Full text in Research Archive
• Drolsum, Liv; Willoch, Christian & Nicolaissen, Bjørn (2006). Use of amniotic membrane as an adjuvant in refractory glaucoma. Acta Ophthalmologica Scandinavica. ISSN 1395-3907. 84(6), p. 786–789. Full text in Research Archive
• Bakke, Espen & Drolsum, Liv (2006). Iris microhaemangiomas and idiopathic juxtafoveolar retinal telangiectasis. Acta Ophthalmologica Scandinavica. ISSN 1395-3907. 84(6), p. 818–822. Full text in Research Archive

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• Noor, L.; Bjerkreim, Hilde; Five, Christian K.; Haugaa, Kristina Ingrid Helena Hermann; Drolsum, Liv Kari & Kristianslund, Olav (2024). Prevalence of keratoconus in persons with mitral valve prolapse in a nationwide register study. Acta Ophthalmologica. ISSN 1755-375X. doi: 10.1111/aos.16786. Full text in Research Archive
• Kristianslund, Olav & Drolsum, Liv (2017). Late in-the-bag intraocular lens dislocation: a randomised trial comparing refractive outcomes and astigmatism after lens repositioning vs lens exchange. Full text in Research Archive
• Kristianslund, Olav & Drolsum, Liv (2017). Late in-the-bag intraocular lens dislocation, high intraocular pressure and glaucoma: a randomised clinical trial comparing lens repositioning and lens exchange. Full text in Research Archive
• Kristianslund, Olav & Drolsum, Liv (2016). Sen dislokasjon av IOL/kapsel-apparatet: en randomisert klinisk studie med sammenlikning av to operasjonsmetoder. Full text in Research Archive
• Kristianslund, Olav & Drolsum, Liv (2016). A randomised controlled trial comparing two operation methods for late in-the-bag intraocular lens dislocation. Full text in Research Archive
• Gram, Camilla; Krohn-Hansen, Dag; gulliksen, eli; Moe, Morten Carsten; Drolsum, Liv & Nicolaissen, Bjørn [Show all 7 contributors for this article] (2014). Ex Vivo Expansion of Human Oral Mucosal Epithelial Cells: Serum Selection Is a Determinant Factor for Cell Proliferation, Differentiation and Gene Expression. Investigative Ophthalmology and Visual Science. ISSN 0146-0404. 55(13), p. 2766–2766. Full text in Research Archive
• Gram, Camilla; Krohn-Hansen, Dag; Gulliksen, Elin Hegstad; Haug, Kristiane; Slettedal, Jon Klokk & Moe, Morten Carsten [Show all 9 contributors for this article] (2013). Characterization of cultivated Human Oral Mucosal Epithelial Cells (HOMEs) in an autologous culture medium. Investigative Ophthalmology and Visual Science. ISSN 0146-0404. 54(15), p. 6035–6035. Full text in Research Archive
• Haughom, Bente & Drolsum, Liv (2010). Two-year data from the cornea registry in Oslo. Acta Ophthalmologica. ISSN 1755-375X. 88, p. 38–38. Full text in Research Archive
• Drolsum, Liv & Ostern, AA (2010). Late in-the-bag spontaneous intraocular lens dislocation. Acta Ophthalmologica. ISSN 1755-375X. 88, p. 6–6. Full text in Research Archive
• Thorsrud, Andreas; Jalil, J. & Drolsum, Liv (2010). Results of collagen cross-linking for corneal ectasia performed in Oslo University hospital 2007-2009. Acta Ophthalmologica. ISSN 1755-375X. 88, p. 28–28. Full text in Research Archive
• Raeder, Sten; Utheim, Tor Paaske; Utheim, Øygunn Aass; Nicolaissen, Bjørn; Roald, Borghild & Cai, Yiqing [Show all 12 contributors for this article] (2007). Effects of Organ Culture and Optisol-GS Storage on Structural Integrity, Phenotypes, and Apoptosis in Cultured Corneal Epithelium. Investigative Ophthalmology and Visual Science. ISSN 0146-0404. Full text in Research Archive
• Drolsum, Liv (2007). Bakre lamellære korneatransplansjoner. Full text in Research Archive
• Drolsum, Liv (2007). Kontaktlinsekurs 2. Videreutdannelse for optikere på Kongsberg. Full text in Research Archive
• Drolsum, Liv (2007). Kursleder: Behandling av sykdommer i hornhinnen. Full text in Research Archive
• Drolsum, Liv (2007). Moderator på symposium: Cataract surgery. Full text in Research Archive
• Drolsum, Liv (2007). Kontaktlinsekurs 1. Videreutdannelse for optikere på Kongsberg. Full text in Research Archive
• Drolsum, Liv (2007). Underviste om øyekirurgi for operasjonssykeleierstudenter. Full text in Research Archive
• Drolsum, Liv (2007). Foredrag for optikerstudenter: Katarakt. Full text in Research Archive
• Drolsum, Liv (2007). Sykdommer i hornhinnen. Full text in Research Archive
• Drolsum, Liv (2007). Nye behandlingstilbud ved hornhinnesykdommer. Full text in Research Archive
• Drolsum, Liv (2007). Nye behandlingsmetoder innen hornhinnekirurgi. Full text in Research Archive

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