Digital Public Defence: Marius Dalby

MD Marius Dalby at Institute of Clinical Medicine will be defending the thesis “Reflections from a randomized clinical trial of late in-the-bag intraocular lens dislocation surgery: Long-term clinical outcomes and a health economic evaluation” for the degree of PhD (Philosophiae Doctor).

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Photo: Geir A. Qvale, Øyeavdelingen, Oslo Universitetssykehus

The public defence will be held as a video conference over Zoom.

The defence will follow regular procedure as far as possible, hence it will be open to the public and the audience can ask ex auditorio questions when invited to do so.

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Download Zoom here

Due to copyright reasons, an electronic copy of the thesis must be ordered from the faculty. In order for the faculty to have time to process the order, it must be received by the faculty no later than 2 days prior to the public defence. Orders received later than 2 days before the defence will not be processed. Inquiries regarding the thesis after the public defence must be addressed to the candidate.

 

Digital Trial Lecture – time and place

See Digital Trial Lecture.

Adjudication committee

  • First opponent: Adjunct Professor Kari Krootila, Helsinki University Hospital, Finland
  • Second opponent: Professor Maria Kugelberg, St. Eriks Ögonsjukehus, Karolinska Institutet, Sweden
  • Third member and chair of the evaluation committee: Professor Pål Gulbrandsen, Faculty of Medicine, University of Oslo

Chair of the Defence

Professor Emeritus Knut Gjesdal, Faculty of Medicine, University of Oslo

Principal Supervisor

Professor II Liv Drolsum, Faculty of Medicine, University of Oslo

Summary

Dislocation of an intraocular lens (IOL) inside the capsular bag may occur many years after uncomplicated cataract surgery and is often referred to as late in-the-bag IOL dislocation. The condition is one of the most common long-term complications after cataract surgery and if it gives visual impairment or severe ocular symptoms related to the loose lens, surgery is recommended.

There are several surgical approaches available, however, there has been no clear consensus on the preferable approach for different patients. This first randomized clinical trial of late in-the-bag IOL dislocation surgery compared IOL repositioning with scleral sutures versus IOL exchange with a retropupillary iris-claw lens. The thesis aimed to evaluate the long-term clinical outcomes and to perform a health economic evaluation of the two different treatments.

The long-term efficacy in terms of visual acuity was similar for the two treatment groups and the overall visual prognosis was good for these patients after surgical treatment. In terms of safety, the treatment groups had similar long-term complication profiles. The most common long-term complication in both groups was cystoid macular edema. Redislocation, a former argument against repositioning surgery, was rarely seen. The 2-year longitudinal corneal endothelial cell loss was similar for the two surgical groups, suggesting equal safety for the corneal endothelium from a long-term perspective.

In the health economic comparison repositioning surgery tended to be more cost-effective; however, adjustment for different surgical time consumption offset the difference in cost-effectiveness. Hence, cost-effectiveness alone was not considered sufficient to determine the superior method.

In conclusion, both IOL repositioning with scleral sutures and IOL exchange with a retropupillary iris-claw lens are suitable treatment options that can be recommended in the management of late in-the-bag IOL dislocation.

Additional information

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Published Jan. 20, 2021 10:03 AM - Last modified Feb. 4, 2021 11:18 AM