Advanced search options

Advanced Search Options 🞨

Browse by author name (“Author name starts with…”).

Find ETDs with:

in
/  
in
/  
in
/  
in

Written in Published in Earliest date Latest date

Sorted by

Results per page:

Sorted by: relevance · author · university · dateNew search

You searched for +publisher:"Universiteit Utrecht" +contributor:("Imhof, S.M."). Showing records 1 – 3 of 3 total matches.

Search Limiters

Last 2 Years | English Only

No search limiters apply to these results.

▼ Search Limiters

1. Soeters, N. Applications and advantages of corneal crosslinking for treatment of keratoconus.

Degree: 2015, Universiteit Utrecht

Keratoconus is a corneal disorder in which the cornea becomes cone-shaped due to stromal thinning and corneal weakening. It mainly affects young individuals and although the prevalence is low (1:2000), the impact on quality of life is high. Despite much effort, still no cure has been found for keratoconus. Although it does not cure keratoconus, CXL can be considered a revolutionary contribution, since it is the only treatment option for progressive cases. CXL is a relatively low invasive procedure to increase corneal rigidity. The treatment is performed a follows: after epithelial removal, isotonic riboflavin drops are applied to the cornea for 30 minutes and subsequently ultraviolet-A irradiation starts for 30 minutes. Reasons to remove the epithelium are that it acts a barrier for riboflavin molecules to enter the stroma, in addition to the fact that epithelium absorbs UV light. Due to the removal of epithelium, patients sensate (sometimes intensive) pain during the first postoperative hours, which extinguishes in the next day(s). Other known symptoms are blurry vision and photofobia. Complete healing of the corneal epithelium is generally within 5 days, and the risk of early post-operative complications (3-8%) is mostly related to epithelial healing. Transepithelial CXL whereby the epithelium is left intact might avoid epithelial healing problems and would be a less painful procedure. In general, standard (epithelium-off) CXL has been shown to be an effective treatment with a high success rate (92%) of halting keratoconus progression. In our randomized controlled trial, transepithelial CXL performed significantly less than standard epithelium-off CXL. In 23% of eyes that underwent transepithelial CXL, keratoconus progression continued after 1 year. Progression was halted in 100% in the group with standard epithelium-off CXL. Therefore, we do not recommend replacing the standard CXL treatment for transepithelial CXL. We also analyzed the epithelium-off CXL effect in patients at the pediatric age (<18 years). In young patients, keratoconus progression can be rapid and intervention with CXL has been advised as soon as any clinical sign of progression is noted. For the last years, there is a trend to perform CXL in patients < 18 years directly after the diagnosis is made, instead of waiting for signs of progression (as is the case in adults ≥ 18 years). This is important, since visual acuity is often still very good at this point and although risks of post-operative complications are low, a clear communication with parents and more than average patient care is mandatory when treating young patients. In our study, we found an equally safe result in pediatric patients compared to patients from 18-26 and >26 years old. Furthermore, pediatric patients showed more visual improvement compared to the other groups. An uncertainty in pediatric patients is the duration of the CXL effect. The turnover rate of stromal collagen ranges between 2 and 7 years. Since the renewed collagen might not have the same… Advisors/Committee Members: Imhof, S.M., Koning-Tahzib, N.G. de.

Subjects/Keywords: keratoconus; crosslinking; CXL; topography; pachymetry; keratometry; visual acuity; transepithelial; scleral lens

Record DetailsSimilar RecordsGoogle PlusoneFacebookTwitterCiteULikeMendeleyreddit

APA · Chicago · MLA · Vancouver · CSE | Export to Zotero / EndNote / Reference Manager

APA (6th Edition):

Soeters, N. (2015). Applications and advantages of corneal crosslinking for treatment of keratoconus. (Doctoral Dissertation). Universiteit Utrecht. Retrieved from http://dspace.library.uu.nl:8080/handle/1874/311050

Chicago Manual of Style (16th Edition):

Soeters, N. “Applications and advantages of corneal crosslinking for treatment of keratoconus.” 2015. Doctoral Dissertation, Universiteit Utrecht. Accessed March 09, 2021. http://dspace.library.uu.nl:8080/handle/1874/311050.

MLA Handbook (7th Edition):

Soeters, N. “Applications and advantages of corneal crosslinking for treatment of keratoconus.” 2015. Web. 09 Mar 2021.

Vancouver:

Soeters N. Applications and advantages of corneal crosslinking for treatment of keratoconus. [Internet] [Doctoral dissertation]. Universiteit Utrecht; 2015. [cited 2021 Mar 09]. Available from: http://dspace.library.uu.nl:8080/handle/1874/311050.

Council of Science Editors:

Soeters N. Applications and advantages of corneal crosslinking for treatment of keratoconus. [Doctoral Dissertation]. Universiteit Utrecht; 2015. Available from: http://dspace.library.uu.nl:8080/handle/1874/311050


Universiteit Utrecht

2. Visser, E.S. Objective and subjective performance of scleral lenses and new advances in scleral lens technologies.

Degree: 2015, Universiteit Utrecht

Scleral lenses are widely recognized for their ability to markedly improve quality of life and giving back patients their ability to perform daily activities, mainly as a result of restoring visual function and/or reduction of ocular discomfort and pain.Scleral lenses are an important front-line tool for managing many corneal disorders refractory to other treatment measures and that otherwise would require keratoplasty. These disorders include conditions in which the cornea requires suitable optical correction in irregular surface, as well as to relieve symptoms, provide mechanical correction and/or facilitate corneal healing in ocular surface disease. The fundaments for the research projects in this thesis started with the development of two key innovations (back-surface toric and tangential design) in scleral lenses by our team. These innovations are important steps towards maximizing patient comfort and optimizing scleral lens performance. The clinical and patient-oriented benefits of these internationally renowned breakthroughs are discussed in this thesis. This thesis starts with a general introduction of the fundamental properties, complications, and indications of scleral lenses. Subsequently the role of scleral lenses in the context of other contact lens types is examined and made accessible for practitioners, by supplying a lens selection algorithm. Furthermore the focus of the research is on the indications and performance of modern scleral lenses, including the recent advances in scleral lens technologies (i.e., back-surface toric and tangential scleral lenses). Lastly, the use of scleral lenses following a relatively new treatment option for keratoconus (corneal crosslinking, or CXL) is evaluated, and the effect of scleral lens use on corneal physiology is examined. Advisors/Committee Members: Imhof, S.M., Lelij, A. van der.

Subjects/Keywords: scleral lens; keratoconus; keratoplasty; dry eye disease; corneal crosslinking

Record DetailsSimilar RecordsGoogle PlusoneFacebookTwitterCiteULikeMendeleyreddit

APA · Chicago · MLA · Vancouver · CSE | Export to Zotero / EndNote / Reference Manager

APA (6th Edition):

Visser, E. S. (2015). Objective and subjective performance of scleral lenses and new advances in scleral lens technologies. (Doctoral Dissertation). Universiteit Utrecht. Retrieved from http://dspace.library.uu.nl:8080/handle/1874/322813

Chicago Manual of Style (16th Edition):

Visser, E S. “Objective and subjective performance of scleral lenses and new advances in scleral lens technologies.” 2015. Doctoral Dissertation, Universiteit Utrecht. Accessed March 09, 2021. http://dspace.library.uu.nl:8080/handle/1874/322813.

MLA Handbook (7th Edition):

Visser, E S. “Objective and subjective performance of scleral lenses and new advances in scleral lens technologies.” 2015. Web. 09 Mar 2021.

Vancouver:

Visser ES. Objective and subjective performance of scleral lenses and new advances in scleral lens technologies. [Internet] [Doctoral dissertation]. Universiteit Utrecht; 2015. [cited 2021 Mar 09]. Available from: http://dspace.library.uu.nl:8080/handle/1874/322813.

Council of Science Editors:

Visser ES. Objective and subjective performance of scleral lenses and new advances in scleral lens technologies. [Doctoral Dissertation]. Universiteit Utrecht; 2015. Available from: http://dspace.library.uu.nl:8080/handle/1874/322813

3. Wisse, R.P.L. Keratoconus : Inflammatory associations and treatment characteristics.

Degree: 2015, Universiteit Utrecht

De corneachirurgie heeft grote veranderingen ondergaan in het afgelopen decennium. Een overzicht van deze ontwikkelingen wordt gegeven in het inleidende hoofdstuk 1. Opvallend is dat de nieuwere lamellaire operaties toch minder uitgevoerd wordt dan de perforerende transplantatie, gebaseerd op data van de Nederlandse Orgaan Transplantatie Registratie, zie hoofdstuk 2. Dit suggereert een kloof tussen de voorlopers die hun bevindingen rapporteren, en het werkveld van cornea chirurgen. Hoofdstuk 3 beschrijft een trial waar de toegevoegde waarde van twee lamellaire technieken vergeleken werd. De beoogde power werd niet behaald en valide uitspraken over de toegevoegde waarde van enige therapie kunnen niet gedaan worden. Eén waarneming blijft overeind betreffende het moeilijke evenwicht tussen trial verplichtingen en chirurgische innovaties. Wat is nu de waarde van een trial als het evidence-based medicine antwoorden biedt voor de procedure van gisteren? De innovaties betreffende de conservatieve visuele rehabilitatie zijn beschreven in hoofdstuk 4. Scleralenzen worden in onze academische praktijk veelvuldig toegepast en de uitkomsten op patiëntniveau zijn goed. De komst corneal crosslinking heeft geleid tot een paradigmaverschuiving. Trans-epitheliale crosslinking bleek veilig te zijn, echter minder effectief om progressieve keratoconus te stoppen, zie hoofdstuk 5. Uitkomsten van crosslinking zijn voorspelbaar in termen van (on) gecorrigeerde gezichtsscherpte en keratometrie. Een predictiemodel wordt beschreven in hoofdstuk 6. Hoofdstuk 7 beschrijft de veranderingen in complexere refractieafwijkingen kenmerkend voor keratoconus; de hoge orde aberraties. Veranderingen in hogere orde aberraties lijkt geen onafhankelijk effect te hebben om de visus één jaar na crosslinking. De biomechanische eigenschappen van de cornea veranderen na crosslinking, wat een oogdrukmeting kan beïnvloeden. Een alternatieve techniek wordt beschreven in hoofdstuk 8. Deze transpalpebrale manier om oogdruk af te leiden blijkt echter te onbetrouwbaar om bruikbaar te zijn in de klinische praktijk, specifiek voor keratoconus patiënten. Er is toenemend bewijs dat verschillende inflammatoire pathways een rol spelen in het ontstaan of verergeren van keratoconus. Een systematic review waarin de bijdrage van celullaire en oplosbare mediatoren (cytokines) in de traanfilm uiteenzet, is weergegeven in hoofdstuk 9. Cellulaire veroudering lijkt een rol te spelen in de pathogenese van keratoconus. Wij vonden dat een aantal belangrijke onderdelen van de mTORC1 pathway aanzienlijk meer tot expressie komt in keratoconus, met inbegrip van mTOR zelf, en genen als RAPTOR, IGF-1, IGF1R, en AKT1, beschreven in hoofdstuk 10. We konden niet overtuigend aantonen dat er verschillende niveaus van DNA-schade bestaan voor keratoconus cornea’s, gezonde controles, of zieke controles (gedecompenseerde grafts). Hoofdstuk 11 trekt het concept van mogelijk onvoldoende DNA-reparatie in keratoconus ogen hiermee in twijfel , temeer omdat een klinische relatie tussen blootstelling… Advisors/Committee Members: Imhof, S.M., Lelij, A. van der.

Subjects/Keywords: Keratoconus; cross linking; inflammation; transplantation

Record DetailsSimilar RecordsGoogle PlusoneFacebookTwitterCiteULikeMendeleyreddit

APA · Chicago · MLA · Vancouver · CSE | Export to Zotero / EndNote / Reference Manager

APA (6th Edition):

Wisse, R. P. L. (2015). Keratoconus : Inflammatory associations and treatment characteristics. (Doctoral Dissertation). Universiteit Utrecht. Retrieved from http://dspace.library.uu.nl:8080/handle/1874/325112

Chicago Manual of Style (16th Edition):

Wisse, R P L. “Keratoconus : Inflammatory associations and treatment characteristics.” 2015. Doctoral Dissertation, Universiteit Utrecht. Accessed March 09, 2021. http://dspace.library.uu.nl:8080/handle/1874/325112.

MLA Handbook (7th Edition):

Wisse, R P L. “Keratoconus : Inflammatory associations and treatment characteristics.” 2015. Web. 09 Mar 2021.

Vancouver:

Wisse RPL. Keratoconus : Inflammatory associations and treatment characteristics. [Internet] [Doctoral dissertation]. Universiteit Utrecht; 2015. [cited 2021 Mar 09]. Available from: http://dspace.library.uu.nl:8080/handle/1874/325112.

Council of Science Editors:

Wisse RPL. Keratoconus : Inflammatory associations and treatment characteristics. [Doctoral Dissertation]. Universiteit Utrecht; 2015. Available from: http://dspace.library.uu.nl:8080/handle/1874/325112

.