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Putri, Rizqi Suryani
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Health Professions Medicine & Pharmacology Public Health

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Bleb Needling Procedure in Juvenile Open Angle Glaucoma (JOAG) for Failed Bleb in Trabeculectomy: Poster Presentation - Case Report - General practitioner Putri, Rizqi Suryani; Nuradianti, Lydia
Majalah Oftalmologi Indonesia Vol 49 No S2 (2023): Supplement Edition
Publisher : The Indonesian Ophthalmologists Association (IOA, Perhimpunan Dokter Spesialis Mata Indonesia (Perdami))

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35749/m1y43690

Abstract

Introduction : JOAG is less responsive to medications and often requires surgical therapy. The main choice of surgery is trabeculectomy. One of its success rates is determined by the formation of bleb. Failed bleb causes an increase in IOP. To repair the bleb, bleb needling can be performed as a simple procedure. Case Illustration : A 7-year-old boy came with a chief complaint of pain accompanied by redness of the left eye. The patient was diagnosed with JOAG and had underwent trabeculectomy with mitomycin-C (MMC) 3 months ago on the right eye and 2 months ago on the left eye with complete success surgery. On physical examination, intraocular pressure (IOP) was 12 mmHg / 29 mmHg with flat bleb on the left eye. Visual acuity on the right eye was 3/10 with cc C-2.00 X 0° ? 7/10 while on the left eye was light perception without possible refractive correction. Timolol maleate and latanoprost eye drops were given for 2 weeks but the IOP remained high. Therefore, the patient underwent bleb needling with 5- Fluorouracil (5-FU) on the left eye. Post-operatively, the IOP was 12 mmHg without antiglaucoma medication. Discussion : Failure of the trabeculectomy bleb can occur due to fibrotic proliferation as part of the wound healing response. Studies stated 5-FU bleb needling provide clinically significant IOP lowering and minimal complication. Reduced IOP post needling and formation of bleb indicate successful needling. Conclusion : Bleb is an important indicator of a success trabeculectomy surgery. Bleb needling with 5-FU could be considered as effective and safe procedure after trabeculectomy failure.
New Generation of Small Incision Lenticule Extraction (SMILE) Procedure for Myopic Astigmatism with High Astigmatism Value : A Case Series: Poster Presentation - Case Series - General practitioner Putri, Rizqi Suryani; Dharmawidiarini, Dini; Moenir, Farida; Napitupulu, Sahata P . H.
Majalah Oftalmologi Indonesia Vol 49 No S2 (2023): Supplement Edition
Publisher : The Indonesian Ophthalmologists Association (IOA, Perhimpunan Dokter Spesialis Mata Indonesia (Perdami))

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35749/zeb7s487

Abstract

Introduction : Myopic astigmatism is a refractive disorder which could cause visual impairment especially with high astigmatism value. It affects patients’ productivity and quality of life. The management for myopic astigmatism is challenging because no consensus on the ideal method was reached. Case Illustration : Case 1: 19-year-old male with Uncorrected Visual Acuity (UCVA) 3/60 in the right eye with a manifest refraction of S-3.25 C-2.00 x 0 and 2/60 in the left eye with a manifest refraction S-5.50 C-0.50 x 0. Case 2: 18-year-old male with UCVA 3/60 in both eyes with a manifest refraction of S-3.00 C-2.25 x 5 and S-2.50 C-2.00 x 0. Case 3: 18-year-old male with UCVA 3/60 in both eyes witha manifest refraction of S-2.75 C-2.00 x 0 and S-2.50 C-2.25 x 180. Slit lamp, fundus examination, corneal topography, tomography, epithelial thickness profile, and aberrometry were within normal limits. The patients underwent SMILE using Visumax 800 Femtosecond laser with 3-4 mm incision at 120°, optical zone between 6-6.8 mm and cap thickness between 100-120 ?m. Discussion : In this case series, SMILE was chosen because studies described SMILE as an effective and safe refractive procedure compared to Femtosecond Laser-assisted in situ keratomileusis (FS-LASIK). Target refraction is emmetropia without cyclotorsion adjustment, it showed that post operative UCVA in all eyes were 6/6 using Snellen chart and none of the eyes loss the BCVA. Conclusion : New Generation of SMILE as management of myopic astigmatism with high astigmatism value shows good result improving visual outcomes.
Co-Authors Dharmawidiarini, Dini Moenir, Farida Napitupulu, Sahata P . H. Nuradianti, Lydia