Jesper Hjortdal

Glostrup Hospital, Glostrup, Capital Region, Denmark

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Publications (173)385.13 Total impact

  • No preview · Conference Paper · Apr 2016
  • Kåre Clemmensen · Anders Ivarsen · Jesper Hjortdal
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    ABSTRACT: Purpose: To examine the optical effects of Descemet stripping automated endothelial keratoplasty (DSAEK) by evaluating changes in anterior and posterior corneal curvatures and aberrations. Methods: Eighty-three eyes treated using DSAEK combined with cataract surgery (the DSAEK group) and 41 control eyes of healthy patients (the control group) were included. Patients were examined before and 1 year after surgery with autokeratometry and Pentacam (Oculus Optikgeräte GmbH, Wetzlar, Germany). The preoperative posterior corneal curvature was estimated from the anterior corneal curvature. Results: The mean intended postoperative refraction in the DSAEK group was -0.75 ± 0.62 diopters (D), which was statistically different from the achieved refraction of +0.50 ± 0.93 D at the 1-year follow-up (P < .001). The average biometry prediction error was a hyperopic shift of +1.27 ± 0.80 D. Anterior corneal power was significantly higher before than after DSAEK with a difference of -0.63 ± 0.68 D (P = .03) correlating significantly with the hyperopic change (r(2) = 0.23, P < .01). The posterior corneal power after DSAEK showed a significant steepening of -0.69 ± 0.38 D (P < .01) from the estimated preoperative power and a difference of -0.64 ± 0.38 D (P < .01) from the posterior corneal power in the control group. The change correlated significantly with the hyperopic change (r(2) = 0.10, P < .01). The combined changes in anterior and posterior keratometry increased the correlation coefficient to r(2) = 0.34 (P < .01). Significant differences were observed for total higher-order aberrations root mean square and coma root mean square after DSAEK compared to controls. No significant changes were observed in spherical aberration. Conclusions: The hyperopic shift in the DSAEK group can be explained by changes in anterior and posterior corneal surfaces. Spherical aberration was not changed by DSAEK, suggesting that aspherical intraocular lenses may be implanted on the same indications as in normal cataract surgery. [J Refract Surg. 2015;31(12):807-812.].
    No preview · Article · Dec 2015 · Journal of refractive surgery (Thorofare, N.J.: 1995)
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    ABSTRACT: The aim of this study was to test the use of BioCornea, a fish scale-derived collagen matrix for sealing full-thickness corneal perforations in mini-pigs. Two series of experiments were carried out in 8 Lan-Yu and 3 Göttingen mini-pigs, respectively. A 2mm central full thickness corneal perforation was made with surgical scissors and 2mm trephines. The perforations were sealed immediately by suturing BioCornea to the wounded cornea. The conditions of each patched cornea were followed-up daily for 3 or 4 days. Status of operated eyes was assessed with slit lamp examination or optical coherence tomography (OCT). Animals were sacrificed after the study period and the corneas operated were fixated for histological examination. Both OCT imaging and handheld slit lamp observations indicated that a stable ocular integrity of the perforated corneas was maintained, showing no leakage of aqueous humor, normal depth of anterior chamber and only mild swelling of the wounded cornea. Hematoxylin and eosin staining of the patched cornea showed no epithelial ingrowths to the perforated wounds and no severe leucocyte infiltration of the stroma. The fish scale-derived BioCornea is capable to seal full-thickness corneal perforation and stabilize the integrity of ocular anterior chamber in pre-clinic mini-pig models. BioCornea seems to be a safe and effective alternative for emergency treatment of corneal perforations.
    Preview · Article · Nov 2015 · PLoS ONE
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    ABSTRACT: We performed a systematic review and meta-analysis to evaluate the benefit and harms associated with implantation of toric intraocular lenses (IOLs) during cataract surgery. Outcomes were postoperative uncorrected distance visual acuity (UCDVA) and distance spectacle independence. Harms were evaluated as surgical complications and residual astigmatism.
    Full-text · Article · Nov 2015 · Ophthalmology

  • No preview · Article · Nov 2015
  • Iben Bach Pedersen · Anders Ivarsen · Jesper Hjortdal
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    ABSTRACT: Purpose: To assess the 3-year refractive and visual outcomes after small incision lenticule extraction (SMILE) in patients with high myopia and to evaluate the optical changes from 3 months to 3 years after surgery. Methods: A total of 87 eyes (87 patients) undergoing SMILE for high myopia were included. Preoperative and 3-month and 3-year postoperative follow-up examinations included manifest refraction and uncorrected and corrected distance visual acuities. Pentacam HR (Oculus Optikgeräte, Wetzlar, Germany) was used to evaluate the total corneal refractive power and the root mean square of spherical aberration, coma, and total higher-order aberrations. The paired t test and Wilcoxon signed rank test were used. Results: The preoperative spherical equivalent averaged -7.30 ± 1.40 diopters (D); no significant changes occured between 3 months and 3 years after surgery (-0.30 ± 0.50 D vs -0.40 ± 0.60 D, P = .071). Uncorrected distance visual acuity was stable from 3 months to 3 years after SMILE (0.04 ± 0.17 logMAR vs 0.03 ± 0.19 logMAR; P = .28), whereas corrected distance visual acuity improved from -0.05 ± 0.15 to -0.08 ± 0.11 logMAR (P < .001). At 3 months, 82% and 93% of eyes were within ±0.50 and ±1.00 D, respectively. At 3 years, 78% and 90% were within ±1.00 D of the attempted refraction, respectively. Spherical and higher-order aberrations significantly decreased from 3 months to 3 years, whereas coma remained stable. A significant regression of 0.36 ± 0.29 D was seen in total corneal refractive power (P < .001). Conclusions: The refractive and visual outcomes seemed stable years after SMILE. A minor myopic regression was observed in total corneal refractive power but not in subjective refraction. There seems to be a significant long-term improvement in higher-order aberrations after surgery. [J Refract Surg. 2015;31(10):XX-XX.].
    No preview · Article · Oct 2015 · Journal of refractive surgery (Thorofare, N.J.: 1995)
  • N. Blom · A. Andreasen · S. Heegaard · J. Hjortdal · K. Nielsen

    No preview · Conference Paper · Oct 2015
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    ABSTRACT: The aim of the present systematic review was to examine the benefits and harms associated with immediate sequential bilateral cataract surgery (ISBCS) with specific emphasis on the rate of complications, postoperative anisometropia, and subjective visual function in order to formulate evidence-based national Danish guidelines for cataract surgery. A systematic literature review in PubMed, Embase, and Cochrane central databases identified three randomized controlled trials that compared outcome in patients randomized to ISBCS or bilateral cataract surgery on two different dates. Meta-analyses were performed using the Cochrane Review Manager software. The quality of the evidence was assessed using the GRADE method (Grading of Recommendation, Assessment, Development, and Evaluation). We did not find any difference in the risk of complications or visual outcome in patients randomized to ISBCS or surgery on two different dates. The quality of evidence was rated as low to very low. None of the studies reported the prevalence of postoperative anisometropia. In conclusion, we cannot provide evidence-based recommendations on the use of ISBCS due to the lack of high quality evidence. Therefore, the decision to perform ISBCS should be taken after careful discussion between the surgeon and the patient.
    Full-text · Article · Sep 2015 · Journal of Ophthalmology
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    ABSTRACT: Tear film proteins adhere to the surface of contact lenses (CLs). While the proteins in the tears have been extensively studied with various proteomic techniques, adhered proteins to CLs are less studied. In this pilot study, we have separated proteins with 2D gel electrophoresis prior to the conventional mass spectrometry (MS) in order to analyse the deposited proteins on hydrogel CLs from myopic patients. pHEMA and PVA hydrogel CLs worn by 3 patients for different time lengths were analysed. After wear, the CLs were frozen at -20°C. Proteins were extracted in lysis buffer, separated on 12% polyacrylamide gels and silver-stained. Protein spots were excised and identified with liquid chromatography - tandem MS. Deposited proteins were extracted with a yield of 26-66 μg and separated by 2D gel electrophoresis. The silver-stained gels showed similar protein patterns independent of the patient, hydrogel type and wear time. Seventy-two spots were analysed with MS, representing at least 12 different tear film proteins or protein fragments. Deposited tear film proteins from a single set of CLs worn for 1 day can successfully be analysed first with 2D gel electrophoresis and subsequently with MS, thus making examination of individual patients possible. The protein composition appeared homogeneous between the test persons which is a necessity for additional comparison analysis. The molecular masses of the identified proteins indicate that protein degradation occurs only as a minor event. Myopic patients were investigated in this pilot study, but the combined techniques can easily be applied to other eye diseases. © 2015 Acta Ophthalmologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.
    No preview · Article · Jul 2015 · Acta ophthalmologica
  • Maria Hovlykke · Anders Ivarsen · Jesper Hjortdal
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    ABSTRACT: To evaluate the impact of venting incisions on the best corrected visual acuity (BCVA), astigmatism, aberrations, and risk of graft detachment in Descemet stripping automated keratoplasty (DSAEK). This was a retrospective, comparative, consecutive case series of DSAEK procedures performed with (n = 266) and without (n = 110) venting incisions. Patients were treated with DSAEK for Fuchs' endothelial dystrophy at Aarhus University Hospital between 2011 and 2013. Data included preoperative keratometry and postoperative BCVA, subjective astigmatism, and Pentacam® HR tomography with corneal front surface (CFS) aberrations at 1 to 2 years of follow-up. Numbers of triple procedures (concurrent cataract surgery) and post-operative graft detachments were also noted. The venting and non-venting groups were compared by the data-means. Unpaired t-tests and Mann-Whitney tests were used for normally and non-normally distributed data, respectively. Differences in graft detachments were analyzed with Fisher's exact and Chi square test. There was no significant difference in any parameter, except the numbers of triple procedures. BCVA (logMAR) was 0.25 ± 0.18 in the venting group and 0.25 ± 0.19 in the non-venting group (p = 0.92), subjective astigmatism was -1.53 ± 0.99 diopters and -1.33 ± 0.78 diopters (p = 0.15), respectively. CFS astigmatism and higher order aberrations were statistically uniform. The relative risk (RR) of graft detachment was also uniform between the venting versus non-venting group (RR 0.72, p = 0.40), and between triple versus non-triple procedures (RR 0.71, p = 0.43). The preoperative corneal curvature had no impact on the risk of graft detachment (p = 0.74). Venting incisions in DSAEK do not significantly alter BCVA, astigmatism, CFS aberrations or reduce the risk of graft detachment in triple or non-triple procedures.
    No preview · Article · Jul 2015 · Albrecht von Graæes Archiv für Ophthalmologie
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    Full-text · Article · Jun 2015 · Ophthalmology
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    ABSTRACT: The need for cataract surgery is expected to rise dramatically in the future due to the increasing proportion of elderly citizens and increasing demands for optimum visual function. The aim of this study was to provide an evidence-based recommendation for the indication of cataract surgery based on which group of patients are most likely to benefit from surgery. A systematic literature search was performed in the MEDLINE, CINAHL, EMBASE and COCHRANE LIBRARY databases. Studies evaluating the outcome after cataract surgery according to preoperative visual acuity and visual complaints were included in a meta-analysis. We identified eight observational studies comparing outcome after cataract surgery in patients with poor (<20/40) and fair (>20/40) preoperative visual acuity. We could not find any studies that compared outcome after cataract surgery in patients with few or many preoperative visual complaints. A meta-analysis showed that the outcome of cataract surgery, evaluated as objective and subjective visual improvement, was independent on preoperative visual acuity. There is a lack of scientific evidence to guide the clinician in deciding which patients are most likely to benefit from surgery. To overcome this shortage of evidence, many systems have been developed internationally to prioritize patients on waiting lists for cataract surgery, but the Swedish NIKE (Nationell Indikationsmodell för Katarakt Ekstraktion) is the only system where an association to the preoperative scoring of a patient has been related to outcome of cataract surgery. We advise that clinicians are inspired by the NIKE system when they decide which patients to operate to ensure that surgery is only offered to patients who are expected to benefit from cataract surgery. © 2015 The Authors. Acta Ophthalmologica published by John Wiley & Sons Ltd on behalf of Acta Ophthalmologica Scandinavica Foundation.
    Full-text · Article · Jun 2015 · Acta ophthalmologica

  • No preview · Article · May 2015 · Ophthalmology
  • Esben Nielsen · Jesper hjortdal · Mogens Erlandsen · Anders Ivarsen

    No preview · Conference Paper · May 2015

  • No preview · Article · May 2015 · Cornea
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    Deepali Sandeep Tambe · Anders Ivarsen · Jesper Hjortdal
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    ABSTRACT: To assess the efficacy and safety of topography-guided photorefractive keratectomy (PRK) for keratoconus and to estimate the subsequent risk of progression. This is a retrospective follow-up study. Between 1998 and 2013, 28 eyes of 23 patients (age 17-60) with grade 1-3 keratoconus received topography-guided PRK. Corrected-distance visual acuity (CDVA), keratometry, pachymetry, and corneal topography were assessed before, after 3 months, and at a late follow-up of a median of 7 years after the procedure. Postoperative complications including subsequent keratoplasty were noted. Of the 28 eyes, 5 (18%percnt;) had undergone corneal transplantation at a median of 7 years (range 3-10) after PRK. Four eyes were not available for follow-up. In the remaining 19 eyes, CDVA was improved in 16 eyes (84.3%percnt;), reduced in 2 eyes (10.5%percnt;), and unchanged in 1 eye (5.2%percnt;). Thus, average CDVA had improved from 0.49 logMAR before PRK to 0.27 logMAR at 3 months, and to 0.24 at the long-term follow-up. The mean spherical equivalent was reduced from - 6.2 to -3.7 dpt after 3 months and to -2.1 dpt at the late follow-up. Similarly, the mean cylinder was reduced from -4.2 to -3.0 dpt after 3 months and at the late follow-up. Topography-guided PRK in keratoconus may be effective for reducing myopia and astigmatism and may offer a temporary or permanent alternative to keratoplasty in contact lens-intolerant keratoconus. In the present study, we found a low risk of keratoconus progression after PRK.
    Preview · Article · May 2015 · Case Reports in Ophthalmology

  • No preview · Article · Mar 2015 · Cornea
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    ABSTRACT: Endophthalmitis is one of the most feared complications after cataract surgery. The aim of this systematic review was to evaluate the effect of intracameral and topical antibiotics on the prevention of endophthalmitis after cataract surgery. A systematic literature review in the MEDLINE, CINAHL, Cochrane Library and EMBASE databases revealed one randomized trial and 17 observational studies concerning the prophylactic effect of intracameral antibiotic administration on the rate of endophthalmitis after cataract surgery. The effect of topical antibiotics on endophthalmitis rate was reported by one randomized trial and one observational study. The quality and design of the included studies were analysed using the Cochrane risk of bias tool. The quality of the evidence was evaluated using the GRADE approach. We found high-to-moderate quality evidence for a marked reduction in the risk of endophthalmitis with the use of intracameral antibiotic administration of cefazolin, cefuroxime and moxifloxacin, whereas no effect was found with the use of topical antibiotics or intracameral vancomycin. Endophthalmitis occurred on average in one of 2855 surgeries when intracameral antibiotics were used compared to one of 485 surgeries when intracameral antibiotics were not used. The relative risk (95% CI) of endophthalmitis was reduced to 0.12 (0.08; 0.18) when intracameral antibiotics were used. The difference was highly significant (p < 0.00001). Intracameral antibiotic therapy is the best choice for preventing endophthalmitis after cataract surgery. We did not find evidence to conclude that topical antibiotic therapy prevents endophthalmitis. © 2015 The Authors Acta Ophthalmologica published by John Wiley & Sons Ltd on behalf of Acta Ophthalmologica Scandinavica Foundation.
    Full-text · Article · Mar 2015 · Acta ophthalmologica
  • Anders Gyldenkerne · Anders Ivarsen · Jesper Ø Hjortdal
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    ABSTRACT: To compare corneal curvatures, corneal power calculations, and higher-order aberrations (HOAs) of femtosecond laser-assisted LASIK (FS-LASIK) with small incision lenticule extraction (SMILE) following surgery for moderate to high myopia. A retrospective study of 736 eyes of 368 patients treated with SMILE and 148 eyes of 74 patients treated with FS-LASIK. Preoperative mean spherical equivalent was -7.3 ± 1.5 diopters in the SMILE group and -7.6 ± 1.3 diopters in the FS-LASIK group. Corneal curvatures, corneal power calculations performed by ray tracing, and HOAs measured with Scheimpflug technology before and 3 months after surgery were analyzed. Corneal curvatures changed significantly in the anterior corneal surface, but not in the posterior corneal surface, in both groups; after SMILE, the sagittal curvature was constant for the central 4-mm diameter, in contrast to FS-LASIK where the curvature showed a gradual steepening with increasing diameter. Corneal power calculations were different across the cornea depending on the measurement diameter between the two groups postoperatively. Measured over a 5-mm zone on the total cornea, FS-LASIK induced 0.11 μm more coma (P < .001) and 0.13 μm higher spherical aberration (P < .001) as compared to SMILE; similar results in other HOAs were seen for the anterior corneal surface. Negligible differences in HOAs were induced on the posterior corneal surface. SMILE and FS-LASIK produced distinct changes in anterior corneal shape evident in different postoperative corneal curvatures and power measurements between the two groups. Postoperative HOAs were much lower after SMILE as compared to FS-LASIK. [J Refract Surg. 2015;XX(X):XX-XX.]. Copyright 2015, SLACK Incorporated.
    No preview · Article · Mar 2015 · Journal of refractive surgery (Thorofare, N.J.: 1995)
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    Full-text · Article · Feb 2015 · Ophthalmology

Publication Stats

2k Citations
385.13 Total Impact Points


  • 2015
    • Glostrup Hospital
      Glostrup, Capital Region, Denmark
  • 1995-2015
    • Aarhus University Hospital
      • Department of Ophthalmology
      Aarhus, Central Jutland, Denmark
  • 2014
    • University of Oklahoma Health Sciences Center
      Oklahoma City, Oklahoma, United States
  • 1996-2014
    • Aarhus University
      Aarhus, Central Jutland, Denmark
  • 2001
    • Aalborg University
      Ålborg, North Denmark, Denmark
  • 1996-1997
    • University Medical Center Hamburg - Eppendorf
      • Department of Ophthalmology
      Hamburg, Hamburg, Germany