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All Journal Journal of the Indonesian Medical Association : Majalah Kedokteran Indonesia JKKI : Jurnal Kedokteran dan Kesehatan Indonesia Ophthalmologica Indonesiana
Widyawati, Syska
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Biochemistry, Genetics & Molecular Biology Education Health Professions Medicine & Pharmacology Public Health

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Treatment Strategies of an Iris Implantation Cyst: A Case Report Zarwan, Jessica; Maulidinia, Ayang Rashelda; Siregar, Astrid Mariam Khairani; Widyawati, Syska; Martha, Faraby; Rhendy, Rio
Majalah Oftalmologi Indonesia Vol 51 No 1 (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.v51i1.101726

Abstract

Introduction: Iris cyst can be divided into primary and secondary, both originating from epithelial cells. Although rare, the entity has a high recurrence rate. This clinical case report highlights the treatment strategies to treat and prevent the recurrency of iris cyst. Case Report: We report a rare presentation of a secondary iris cyst in a 20-year-old male with a history of cataract surgery 17 years prior. The patient underwent fine-needle aspiration and intracystic alcohol injection. However, the iris cyst recurred eight months after the procedure. Afterward, the invasive strategy of iris cyst excision was conducted. Eight months after the secondary iris cyst surgery, the patient showed no signs of recurrence. Discussion: Iris cyst is known to have a high recurrence rate, however, a minimally invasive treatment is still preferred, supported by previous studies showing no recurrence in treatment with fine-needle aspiration and intracystic alcohol injection. In our case, the iris cyst relapsed eight months after this procedure, warranting for surgical excision. Eight months after the excision, the patient showed no signs of recurrence. Conclusion: Although the recurrency of iris cyst is high, the authors suggest starting with non-invasive treatment with follow-up ensuring no recurrence before opting for a more invasive treatment.
Karakteristik Klinis dan Kesintasan Keratoplasti Tembus Optik di Layanan Tingkat Tersier di Indonesia: Studi Retrospektif 4 Tahun Widyawati, Syska; Gondhowiardjo, Tjahjono D.; Nora, Rina La Distia; Harniza, Yulika; Samira, Cut Putri; Alberta, Ivana Beatrice
Majalah Kedokteran Indonesia Vol 72 No 6 (2022): Journal of The Indonesian Medical Association - Majalah Kedokteran Indonesia, Vo
Publisher : PENGURUS BESAR IKATAN DOKTER INDONESIA (PB IDI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.47830/jinma-vol.72.6-2022-785

Abstract

Introduction: Purpose, to evaluate patient demographic characteristics, indications and variables related to penetrating keratoplasty (PK) survival. Study design, this study was retrospective case series. Methods: We trace all medical records of PK patients from 2015 to 2018 in Cipto Mangunkusumo Hospital Jakarta. The traced variables were indications of surgery, corneal vascularization, previous failed graft, glaucoma after PK, and other complication. PK survival rate is shown in the Kaplan Meier curve using SPSS v20.0. Results: A total of 214 patients underwent PK (men 67.3%, woman 32,7%) with mean age of 42.11 (0-85) years were included in this study. Three most common indications of keratoplasty were corneal scar (32.7%), infectious corneal ulcer (25.5%), and failed graft (19.2%). The overall graft survival rate for PK is 61.7%. The mean graft survival time was 14.388 ± 0.580 months (95% CI; 13.252-15.524). Conclusion: The graft survival rate for penetrating optic keratoplasty was 61.7%. Establishing an appropriate early diagnosis, reasonable surgical procedures, close monitoring, and early detection of complications with proactive interventions lead to better outcomes. Further research is needed to determine the relationship between the risk factors for corneal graft failure.
 AN ATYPICAL CASE OF BILATERAL CORNEAL OPACITY: WHAT ARE THE POSSIBLE DIAGNOSIS? Zarwan, Jessica; Siregar, Astrid Mariam Khairani; Pintary, Marsha Rayfa; Widyawati, Syska; Martha, Faraby; Rhendy, Rio
Majalah Oftalmologi Indonesia Vol 50 No 1 (2024): 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/c1s1j485

Abstract

Introduction: Corneal opacity can be divided into inflammatory and noninflammatory entities. The clinical presentation and characteristics of a corneal opacity can often help reach a diagnosis. However, atypical cases are more challenging to diagnose. This report aims to explore an atypical case of corneal opacity and the diagnostic approach through its clinical presentation. Case Report: A thirty-seven-year-old female patient had a chief complaint of gradual blurry vision in both eyes and slowly growing whitish lesions one year prior. The patient recalled a history of bilateral eye redness two years ago. The anterior segment examination and AS-OCT revealed bilateral, smooth, oedematous pearly-white elevated opacity with well-demarcated margins at the center of the cornea, with epithelial depth. The diagnosis of corneal keloid was favored, with GDLD and SND as the differential diagnosis. In local anesthesia, the patient underwent superficial keratectomy and amniotic membrane transplantation of the right eye. On one month follow-up, the patient felt an improvement in her subjective complaints with a normal appearance of the cornea. Discussion: The atypical characteristics found in our case didn’t fit a single mold, as it shared features of post- injury hypertrophic scar, degenerative, and dystrophy. We diagnosed the patient with corneal keloid caused by suspicion of subclinical infection. Although GDLD and SND were still possible, the working diagnosis was enough to warrant a therapeutic surgical removal. Conclusion: Atypical presentations make diagnosis more challenging. However, despite improvements in diagnostic modalities, signs, and symptoms remain very helpful in reaching a working diagnosis.
QUALITY OF LIFE AFTER CATARACT SURGERY IN PATIENTS WITH AGE-RELATED MACULAR DEGENERATION:  A LITERATURE REVIEW Syahruzad, Rosa; Widyawati, Syska; Wildan, Arief
Majalah Oftalmologi Indonesia Vol 49 No S1 (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/baw7s775

Abstract

Objective: Age-related macular degeneration (AMD) is a common ocular disease that affects millions of people worldwide. Cataract surgery is one of the most performed surgical procedures in the world and is effective to improve visual function and quality of life (QOL) in individuals with cataracts. Both cataract and AMD are conditions that occur in late age. However, the presence of AMD may complicate the postoperative outcomes and quality of life (QOL) of these patients. This review aims to examine the impact of cataract surgery on the QOL of patients with AMD. Methods: A search of the literature was conducted using electronic databases. Studies were included if they evaluated QOL outcomes in patients with AMD who underwent cataract surgery. Result: The results of the review suggest that cataract surgery can improve visual acuity and QOL in patients with AMD. However, the degree of improvement is influenced by the severity of AMD. Patients with mild to moderate AMD tended to have greater improvements in QOL and visual acuity compared to those with advanced AMD. Incidentally, it is still cost effective to perform cataract surgery in patients with advanced AMD. Conclusion: Overall, cataract surgery is found to be able to improve QOL and visual acuity in patients with AMD. Nevertheless, individual characteristics including severity of AMD must be considered to optimize the outcomes. Further research, particularly with longer follow up times, is needed to determine the long-term effects of cataract surgery on QOL in patients with AMD.
THE USE OF VISUAL FUNCTION INDEX-14 (VF-14) QUESTIONNAIRE IN DETERMINING CATARACT PATIENTS’ QUALITY OF LIFE IN JONGGOL SUBDISTRICT, INDONESIA Safira, Nadya; Fermitaliansyah, Muhammad Keyvan; Widyawati, Syska; Mahyuddin, Mutmainah
Majalah Oftalmologi Indonesia Vol 49 No S1 (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/q1xfw158

Abstract

Introduction and Objective: Unresolved cataract primarily has caused patients to have disturbance in carrying out daily activities, thus lowering their quality of life (QoL). We aim to use the Visual Function Index-14 (VF-14) questionnaire, one of the most frequently used tools, to discover the extent of daily activities disturbance in patients with cataract. Methods: In this observational study, we conducted eye screening to 47 subjects in Jonggol subdistrict, Bogor, Indonesia. Patients were asked several questions based on the translated VF-14 questionnaire into Bahasa and also tested to find out their best-corrected visual acuities. Lens examination was carried on using handheld slit lamp. Result: Out of all 47 subjects, 34 (72,3%) patients had cataract that was marked by lens opacities in either one or both eyes. According to distant vision impairment categories by International Classification of Diseases 11, 8,8% of cataract patients had normal vision from the better eye, 20,6% had mild, 64,7% had moderate, 0% had severe impairment, and 5,9% had blindness. From the assessment using VF-14 translated questionnaire, 14,7% subjects had no disruption in doing daily activities, 82,3% had disruption, and 2,9% could not do the mentioned activities at all. From the Spearman correlation test, there was a significant association with moderate correlation between the degree of vision impairment and QoL (p = 0.006, rs = 0.459). Conclusion: The majority of cataract patients in Jonggol subdistrict had moderate vision impairment and had disruption in doing daily activities, therefore lowering their QoL.
Virna Glaucoma Implant (VGI) as the Management of Secondary Glaucoma following TASS : A Case Report: Poster Presentation - Case Report - General practitioner Presialia, Athira; Witjaksono, Anissa Nindhyatriayu; Anissa, Gisela Haza; Widyawati, Syska
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: 10.35749/4sepeq10

Abstract

Introduction : Secondary glaucoma may occur in severe TASS. The inflammatory cell and debris can clog trabecular meshwork causing IOP to rise. In this case, we describe the successful management of secondary glaucoma due to TASS using Virna Glaucoma Implant (VGI). Case Illustration : A 66-year-old woman presented with decreased vision in the left eye one week after anterior vitrectomy and anterior segment lavage due to TASS. She had a history of phacoemulsification and intraocular lens placement with complication of PCR. On ocular examination, the visual acuity was 1/60 in the left eye with intraocular pressure (IOP) 55 mmHg. After maximum glaucoma medication using timolol, latanoprost, brinzolamide eye-drops and oral acetazolamide IOP was 22mmHg. Glaucoma Drainage Device (GDD) surgery using VGI was performed. After 2.5 weeks, IOP in the left eye was reduced to 19 mmHg without anti-glaucoma medication and visual acuity has improved to 6/60, showing a favourable outcome. Discussion : TASS may cause significant damage to the trabecular meshwork, which leads to secondary glaucoma. Although medical therapy is often used to control elevated IOP, surgical therapy may be required to treat refractor IOP elevation. GDD surgery has been reported to have effective outcomein secondary glaucoma and pseudophakic eyes. Conclusion : Secondary glaucoma is considered as one of the characteristics in the late stages of TASS, and required prompt treatment. VGI implantation is a promising choice of treatment in managing secondary glaucoma following TASS when medication is not effective.
Did the metal object hit the cornea? A case report of penetrating ocular injury with embedded foreign body: Poster Presentation - Case Report - Resident AGUNG NUGROHO; Dearaini; Annisa Windyani; Susantono, Diannisa Paramitha; Pangestika, Rishka; Laksmita, Yulinda Arty; Widyawati, Syska; Adriono, Gitalisa Andayani
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: 10.35749/7fy1ce37

Abstract

Introduction : Penetrating ocular injury with IOFBs may cause severe ocular damage. We demonstrate the diagnostic and treatment approach in a case of scleral laceration with a large IOFB. Case Illustration : A-24-year-old male presented with a rusty segment of fence wire, sized 15x11 mm, embedded near the nasal corneal margin of the right eye. Upon initial examination the vision was 6/9 with normal IOP. The object obstructed the view of the entry site, therefore corneal wound was suspected. CT scan showed penetrating metal object without posterior segment involvement. Anti-tetanus injection, topical and oral levofloxacin were given. He underwent exploration, foreign body removal and repair surgery. During surgery, the wound was revealed as a scleral laceration, 4 mm from nasal limbus. One day post-operative, vision was 6/20. A 0.1 mm hypopyon was found, along with fibrin at nasal vitreous. Oral and topical corticosteroids were given, and hypopyon disappeared the next day. One week after surgery, vision improved to 6/7.5, with clear vitreous and normal retina. Discussion : Ocular injuries with large IOFBs can hinder clinical examination. Corneal entry wound should be ruled out, due to potential permanent damage to visual axis. CT scan was helpful in assessing the depth of object penetration. The object was removed successfully, with no damage to the cornea and retina. Anti-tetanus, antibiotics and corticosteroids were able to control infection and inflammation. Conclusion : Large IOFBs which do not affect the visual axis, can be managed with successful outcome, by prompt removal and repair of the entry wound, and control of infection and inflammation.
Cataract Surgery After Keratoplasty: How Should We Prepare? Poster Presentation - Case Series - Resident Sadikin, Irma Suwandi; Widyawati, Syska
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: 10.35749/5xx1gd17

Abstract

Introduction : Cataract surgery following corneal transplantation demands special attention to corneal graft stability and optimization to allow for excellent IOL selection, as well as corneal graft preservation since lens removal damages the corneal endothelium. This study aimed to determine how we should prepare for cataract surgery after keratoplasty. Case Illustration : Case 1: A 34-year-old male has phacoemulsification in his right eye (last eye). He had a history of eye surgery, including, keratoplasty for RE in 2019, and vitrectomy for RE because of endophthalmitis. The pre-operative visual acuity is 0.5/60 with PAS and an irregular pupil. Post-operative VA 3/60 with BCVA 6/40. Last follow-up, the grafted cornea was still clear with normal IOP. Case 2: A 50- year-old female underwent phacoemulsification for both eyes (BE). She had histories of keratoplasty in 1986, 1989, and 1997 for BE. She also had extreme myopia for BE (RE S -17.00, LE S-14.00). Pre- operative VA was 1/60 of BE, and BCVA was 6/20 a month after surgery. During the last check-up, both transplant corneas were clear with normal IOP. Last visit, her both grafts remained clear. Discussion : Conclusion : IOL calculations are challenging due to inaccuracy in corneal measurements, astigmatism, or corneal pathology. The best time to perform surgery is at least 2 years after keratoplasty. We suggest using total keratometry in the K-6 formula or Haigis for the IOL formula. Good dispersive viscoelastic, operating away from the corneal endothelium, and employing low phaco-energy/fluids will help to deliver a clear cornea after surgery. Last, steroid treatment will enhance graft survival rate.
A Challenging Case of Simple Limbal Epithelial Transplantation (SLET) in Limbal Stem Cell Deficiency Following Chemical Injury: A Case Report: Poster Presentation - Case Report - Resident Amanda, Lia; Widyawati, Syska; Martha, Faraby; Zarwan, Jessica
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/ahx7p888

Abstract

Introduction : Limbal stem cell deficiency (LSCD) often arises following trauma or inflammation that hinders corneal epithelium healing, commonly caused by chemical or thermal injuries. Despite significant advancements, treating LSCD remains challenging. This case highlights a challenging case of simple limbal epithelial transplantation (SLET) in LSCD following chemical injury. Case Illustration : A 20-year-old male presented with reduced vision in left eye following an alkaline chemical injury (grade III) was diagnosed with unilateral LSCD. Upon examination, conjunctivalization of the peripheral cornea, a central corneal cicatrix, and stromal neovascularization present after previous necrotomy, tenoplasty, and amniotic membrane transplantation (AMT). The patient then underwent SLET, with limbal biopsies from the collateral eye. Four months after surgery the visual acuity improved from 3/60 to 6/15 with spectacles. However, the cornea conjunctivalization still developed despite improved visual acuity. Discussion : To effectively manage the recurrence of stem cell deficiency, other stem cell transplantation techniques are needed to manage the problem. Combining different limbal stem cell transplantation approaches can be customised to address the problem and achieve lasting results. Conclusion : Prompt diagnosis and treatment of LSCD is crucial to prevent complications and blindness. SLET is a surgical option for LSCD after chemical injury, but this report highlights a challenging case and the need for the alternatives approaches.
A snake venom ophthalmia: A case – report: Poster Presentation - Case Report - Resident Aljufri, Nabila; Sadikin, Irma Suwandi; Petra, Dany; Susantono, Diannisa; Oktariani, Virna Dwi; Widyawati, Syska
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/vm6dv861

Abstract

Introduction : Snake venom ophthalmia is caused by venoms of spitting snakes. Delayed treatment may result in corneal ulcer, corneal perforation and blindness. We aim to report a fortunate snake venom ophthalmia case. Case Illustration : A-54-year-old male complained of burning eye pain, watery, and redness of the right eye (RE) after being spat by a snake 3 hours before admission. The snake was identified as a cobra-snake, spitted at a distance of 1 meter without body bite. He rinsed his eyes with tap water and irrigated at a nearby hospital before referred. During the admission, the pH of both eyes (BE) was 8. The patient was irrigated with normal-saline. The visual acuity (VA) of the right eye was 6/12 and left eye 6/6. There was RE conjunctival and ciliary injection. Other examinations were unremarkable. The patient was discharged and treated with levofloxacin eye-drop, sulfas-atropine 1%, EDTA 1%, artificial tears, and vitamin C. He did self-eye irrigation. Two days later, he presented with VA of 6/6 for BE with normal ocular examinations and pH of 7 for BE. Discussion : The general principle is prompt and copious irrigation of the eyes in chemical contact. The snake venom mixture of chemicals was washed out, which local necrosis can be prevented. Managing snake venom as a chemical splash injury with considerable irrigation, lubricants, and topical antibiotics, resulted a good outcome and prevented sequelae in this patient. Conclusion : Urgent irrigation of the affected eyes and other mucous membranes is the key in treating snake venom ophthalmia
Co-Authors Agung Nugroho Alberta, Ivana Beatrice Aljufri, Nabila Amanda, Lia Andayani, Gitalisa Anissa, Gisela Haza Annisa Windyani Arief Wildan, Arief Dearaini Fermitaliansyah, Muhammad Keyvan Harniza, Yulika Kania, Theresia Laksmita, Yulinda Arty Made Susiyanti Mahyuddin, Mutmainah Martha, Faraby Maulidinia, Ayang Rashelda Melva Louisa Nora, Rina La Distia Nursakina, Yosilia Oktariani, Virna Dwi Pangestika, Rishka Pangestika, Riskha Petra, Dany Pintary, Marsha Rayfa Presialia, Athira Rancakbudi, Aydan J. Rhendy, Rio Sadikin, Irma Suwandi Safira, Nadya Samira, Cut Putri Siregar, Astrid Mariam Khairani Susanto, Eka Susantono, Diannisa Susantono, Diannisa Paramitha Syahruzad, Rosa Tjahjono D. Gondhowiardjo Waznan, Fadhli Witjaksono, Anissa Nindhyatriayu Zarwan, Jessica