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Caesarya, Sesy
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Health Professions Medicine & Pharmacology Public Health

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Comparison of Different Cycloplegic Refraction Regimens for Children Irfani, Irawati; Gunawan, Fany; Satari, Karmelita; Sari, Maya; Oktarima, Primawita; Caesarya, Sesy; Karfiati, Feti
Majalah Kedokteran Bandung Vol 56, No 3 (2024)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15395/mkb.v56.3311

Abstract

In the process of a pediatric eye exam, cycloplegic refraction is a crucial step. Since no single cycloplegic drug is ideal, a combination regimen is employed. This study compares the ocular (refractive power and pupil diameter) and systemic (blood pressure and heart rate) effects of administering a combination of 1% cyclopentolate and 2.5% phenylephrine, with or without 1% tropicamide, to children with refractive errors. This study aimed to discover a more feasible regimen for children. This was a single-blind study, a randomized clinical trial conducted from November–December 2020 in children with mild to moderate refractive errors. Group A received 1% cyclopentolate, 2.5% phenylephrine, and 1% tropicamide (SFT), whereas group B received 1% cyclopentolate and 2.5% phenylephrine (SF). The outcomes were measured using an auto refractometer and IOL Master® 700. Before and 60 minutes after medication was administered, blood pressure and heart rate were measured. There were 54 participants (108 eyes) with an average age of 12.85± 2.84 years. Although the SFT group's refractive power and pupil width were greater than those of the SF group, the differences were not statistically significant (p=0.271 and p=0.088). Heart rate (p=0.521) and blood pressure (systolic p=0.201; diastolic p=0.950) did not significantly differ between the two groups. Despite mydriasis manifested more rapidly in the SFT group, there was no discernible difference in the cycloplegic effects between those groups. SF might be a more feasible regimen for cycloplegic refraction in children with refractive errors.
Refractive and Visual Outcomes of Pediatric Cataract Surgery in Indonesian Tertiary Eye Center Memed, Feti Karfiati; Santosa, Rizki Adi; Irfani, Irawati; Caesarya, Sesy; Amiruddin, Primawita Oktarima; Kuntorini, Mayasari Wahyu
Majalah Oftalmologi Indonesia Vol 51 No 2 (2025): Ophthalmologica Indonesiana
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/journal.v51i2.101763

Abstract

Introduction: Cataract remains as a leading cause of visual impairment in children. Surgical intervention and post-operative refractive correction remain fundamental. This study aims to describe the refractive and visual outcome of pediatric cataract surgery in a tertiary eye center in Indonesia.   Methods: This retrospective study was conducted utilizing medical records of all congenital and developmental cataracts patients undergoing cataract extraction procedures with or without primary IOL implantation between January and December 2022. Exclusion criteria included patients who did not undergo visual acuity and objective refraction examination 1-month post-cataract surgery and those with incomplete medical records data.   Results: A total of 118 eyes from 65 patients was included in this study. Most patients had bilateral cataracts (93.80%) and operated at the median age of 18 (0.96-212.64) months. Post-operatively, there were 71 (60.19%) aphakic and 47 (39.81%) pseudophakic patients with a respective refractive status of +18.00 (12.00 – 21.13) D and +0.60 (±2.37) D. Prediction error (PE) and absolute prediction error (APE) were obtained within 1.00 D. Most aphakic patients had unquantifiable visual acuity both before (91.50%) and after (83%) surgery. Among pseudophakic patients, nine (19.16%) had visual acuity of ≥ 6/12 and seven (14.89%) had visual acuity of <6/12 - 6/18 post-operatively. No patients had visual acuity ≥ 6/12 and <6/12 - 6/18 before surgery.   Conclusion: Post-operative refractive status of both aphakic and pseudophakic patients were well within correctable range. There was an improvement of vision after surgery. Limited visual potential may be attributed to the presence of amblyopia.
CHALLENGES IN THE SURGICAL MANAGEMENT OF BILATERAL POSTERIOR LENTIGLOBUS: Poster Presentation - Case Report - Resident RAHMANI, SYIFA; Memed, Feti Karfiati; Caesarya, Sesy; Amiruddin, Primawita Oktarima; Irfani, Irawati; Kuntorini, Mayasari Wahyu
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/awdxnd05

Abstract

Introduction : Lentiglobus is a lens deformation characterized by spherical bulging of the lens surface. The weakness of the posterior capsule in the lentiglobus makes the surgery challenging. We present a case of bilateral posterior lentiglobus and its management. Case Illustration : A 5-year-old boy was presented with the chief complaint of gradually blurred vision since 1 year ago. Visual acuity were 0.1 and closed face finger counting in the right and left eyes, respectively. An ophthalmology examination revealed lens opacities with partially reabsorbed lens material and protrusion of the lens surface posteriorly in both eyes (figure 1). The patient was diagnosed with developmental cataracts of the membranous type and posterior lentiglobus in both eyes. The patient underwent a surgical intervention for cataract extraction with aspiration technique. A spontaneous posterior capsule rupture was found with a shape like a lentiglobus. An anterior vitrectomy was performed. An intraocular lens was implanted. At one month after surgery, the best corrected visual acuities were 0.5 in both eyes (figure 2). Discussion : Several difficulties can be encountered during pediatric cataract surgery with the posterior lentiglobus morphology because of the thin or ruptured capsule. Previous studies have found preoperative and intraoperative posterior capsule rupture in 25% and 3.13% of lentiglobus cases, respectively. Hydrodissection should be avoided due to the weakness of the posterior capsule. ConclusionAppropriate surgical techniques to anticipate posterior capsule defects in the lentiglobus are required to produce a favorable outcome.
SUCESSFULL MANAGEMENT OF CHILDHOOD BASIC-TYPE ESOTROPIA IN ADULT PATIENT: Poster Presentation - Case Report - Resident VITRIANA, ANISA; M., Feti Karfiati; Caesarya, Sesy; Amiruddin, Primawita O.; Kuntorini, Mayasari Wahyu; Irfani, Irawati
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/b62wcv21

Abstract

Introduction : Strabismus in adults may indicate other pathological causes, such as neurological disorders or trauma. Diagnosis of esotropia in adult patients has to be made carefully to determine the right treatment. Management’s goal of strabismus in adult patients is mainly cosmetic by diminishing deviation. Case Illustration : A 46-year-old woman, complaint of inward deviation of both eyes since childhood. There were no complaints of double vision, headaches, nor trauma history. Visual acuity of right eye was 0.4 with BCVA and left eye was 0.8 with BCVA 0.8. Hirschberg test was 45o (Figure 2A). Prism cover test was 75 PD base out in near and distance. Patient was diagnosed with basic-type esotropia. The patient already given spectacles but the deviation persisted so she underwent bilateral medial rectus recess surgery (Figure 2B). Ocular alignment without spectacles 1 week after surgery showed orthotropia and small esophoria. (Figure 2C). Discussion : Each esotropia types has a different treatment approach. Basic-type esotropia with large deviation usually needs surgical treatment. Management of childhood onset strabismus in adult patients is challenging because those patients have lesser ability to maintain fusion. Older patients and large deviation are poor prognostic factors to achieve good functional and cosmetics outcome after strabismus surgery. Conclusion : Establishing a definite diagnosis in adult strabismus patients, including esotropia, is challenging. Careful diagnosis and management decision will determine the outcome of the patient’s condition.
Co-Authors Amiruddin, Primawita O. Amiruddin, Primawita Oktarima Feti Karfiati Memed Gunawan, Fany Irawati Irfani Kuntorini, Mayasari Wahyu M., Feti Karfiati Maya Sari Primawita Oktarima Santosa, Rizki Adi Satari, Karmelita Syifa Rahmani, Syifa Vitriana, Anisa