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All Journal Bioscientia Medicina : Journal of Biomedicine and Translational Research
Ramzi Amin
Department of Ophthalmology, Faculty of Medicine, Universitas Sriwijaya/ Dr. Mohammad Hoesin Central General Hospital, Palembang, Indonesia
Biochemistry, Genetics & Molecular Biology Immunology & microbiology Medicine & Pharmacology Neuroscience

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Adjunctive Diquafosol Sodium 3% and Tear-Ferning Recovery After Pars Plana Vitrectomy: An Exploratory Randomized Trial Ramzi Amin; Petty Purwanita; Rizka Yunanda
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 10 No. 5 (2026): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v10i5.1661

Abstract

Background: Ocular-surface disturbance after pars plana vitrectomy (PPV) may impair tear-film stability and mucin-related function. Diquafosol sodium stimulates aqueous and mucin secretion through P2Y₂-receptor signaling, but evidence after PPV remains limited. Objective: This study evaluated adjunctive diquafosol sodium 3% using tear-ferning grade as an exploratory outcome. Methods: This single-center randomized trial enrolled 36 adults after PPV. Participants received diquafosol sodium 3% six times daily for eight weeks plus standard postoperative care (n=18) or standard care alone (n=18). Treatment was open label; tear-ferning assessment was performed by a masked assessor. Ferning grade was measured at postoperative weeks 1, 2, 4, and 8. Between-group comparisons used the Mann–Whitney U test with multiplicity adjustment, and standardized effect magnitudes were summarized using Hedges g with 95% confidence intervals. Results: Mean ferning grades were similar at week 1 (3.94±0.236 vs 3.72±0.461; p=0.203), week 2 (3.67±0.594 vs 3.72±0.461; p=0.938), and week 4 (2.89±0.323 vs 3.00±0.000; p=0.584). At week 8, the diquafosol group had a lower mean grade than the control group (2.11±0.471 vs 2.72±0.461; p=0.003), with a standardized effect magnitude of 1.28 (95% CI 0.57–1.99). No adverse events were reported. Conclusion: Adjunctive diquafosol was associated with better tear-ferning grade at eight weeks after PPV. The finding is exploratory and requires confirmation using larger, multicenter, placebo-controlled trials with multidimensional ocular-surface outcomes.
Feasibility, Visual Outcomes and Severity-Stratified Response to Pre-operative Intravitreal Bevacizumab Before Vitrectomy in Proliferative Diabetic Retinopathy Ramzi Amin; Fajar Prasetya; Abdul Karim Ansyori
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 10 No. 3 (2026): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v10i3.1664

Abstract

Background: Proliferative diabetic retinopathy is a leading cause of vision loss in working-age Indonesians, and pre-operative anti-vascular endothelial growth factor therapy has been proposed to make vitrectomy safer, yet Southeast Asian trial evidence is almost absent. Objective: To assess the feasibility, visual outcomes, and severity-stratified response to pre-operative intravitreal bevacizumab before 23-gauge pars plana vitrectomy in patients with proliferative diabetic retinopathy. Methods: In a single-centre, single-blind pilot randomised controlled trial at the Department of Ophthalmology, Faculty of Medicine, Universitas Sriwijaya/ Dr. Mohammad Hoesin Central General Hospital, Palembang (July–November 2025), 21 adults with proliferative diabetic retinopathy and non-clearing vitreous haemorrhage were allocated 1:1, stratified by haemorrhage severity, to intravitreal bevacizumab 1.25 mg/0.05 mL given 3–7 days before 23-gauge pars plana vitrectomy (n = 11) or to vitrectomy alone (n = 10). Progression criteria were pre-specified; the clinical outcome was best-corrected visual acuity change in LogMAR at one week. Results: All progression criteria fell in the green zone (recruitment 95.5%, 95% CI 78.2–99.2; retention and adherence 100%). Bevacizumab-treated eyes gained more vision, but imprecisely (Hodges–Lehmann shift 0.35 LogMAR, envelope 0.10 to 0.50; Hedges' g 0.65), the trial retaining only 14.8% power for the observed difference. Baseline vitreous haemorrhage severity dominated visual gain (adjusted B -0.397 LogMAR per grade, 95% CI -0.639 to -0.155; Cochran–Armitage trend p = 0.015). Conclusion: Pre-operative bevacizumab is feasible in an Indonesian tertiary centre and warrants a severity-stratified multicentre trial.
Co-Authors Abdul Karim Ansyori Fajar Prasetya Petty Purwanita Rizka Yunanda