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All Journal Medicina E-Jurnal Medika Udayana Jurnal Pengabdian Kepada Masyarakat (Indonesian Journal of Community Engagement) Universa Medicina ISM (Intisari Sains Medis) : Jurnal Kedokteran Bioscientia Medicina : Journal of Biomedicine and Translational Research Bioscientia Medicina : Journal of Biomedicine and Translational Research Vision Science and Eye Health Journal Public Health and Preventive Medicine Archive Journal of Global Pharma Technology Oftalmologi: Jurnal Kesehatan Mata Indonesia Ophthalmologica Indonesiana
Ariesanti Tri Handayani, Ariesanti Tri
Departement Of Ophthalmology, Universitas Udayana
Biochemistry, Genetics & Molecular Biology Decision Sciences, Operations Research & Management Education Health Professions Immunology & microbiology Library & Information Science Medicine & Pharmacology Neuroscience Nursing Public Health

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Tear Reservoir Thickness and Vector-Resolved Refractive Outcomes in Indonesian Corneal Ectasia: A Scleral Lens Pilot Study Anak Agung Ayu Putri Prematura Sri Anasary; Ariesanti Tri Handayani
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 10 No. 2 (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.v10i2.1512

Abstract

Background: Corneal ectasia is characterized by high-order aberrations and irregular astigmatism, presenting significant optical challenges. Scleral lenses neutralize these irregularities via a post-lens tear reservoir. However, the precise optical contribution of the tear reservoir thickness itself to residual refractive error remains under-characterized, particularly in Southeast Asian populations where aggressive ectasia phenotypes are common. This study aimed to determine if tear reservoir thickness correlates with residual refractive error using vector analysis. Methods: This retrospective pilot study analyzed 12 eyes of 8 patients with severe corneal ectasia fitted with scleral lenses in Indonesia. Refractive outcomes were converted to Thibos power vectors (M, J0, J45). To account for bilateral eye correlations, linear mixed models (LMM) were employed with Patient ID as a random effect. A theoretical thick-lens model compared predicted versus observed over-refraction. Results: The cohort (mean age 28 ± 10.2 years) achieved significant visual improvement (LogMAR 0.35 to 0.17; p = 0.005). The mean tear reservoir thickness was 263.33 ± 80.92 μm. LMM analysis revealed no statistically significant correlation between fluid thickness and Spherical Equivalent (M) (beta = -0.001, p = 0.72) or Blur Strength (p = 0.68). The theoretical model indicated that residual error was driven by uncorrected posterior corneal astigmatism rather than fluid depth. Conclusion: In this Indonesian cohort, optical efficacy was driven by refractive index matching at the corneal interface, not reservoir thickness. Clinical fitting should prioritize physiological clearance over refractive manipulation.
Corneal Ectasia After Keratorefractive Surgery: High-Order Aberration Management and Hormonal Considerations Supit, Fabiola; Handayani, Ariesanti Tri
Vision Science and Eye Health Journal Vol. 5 No. 2 (2026): Vision Science and Eye Health Journal
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/vsehj.v5i2.2026.52-57

Abstract

Introduction: To report a case of corneal ectasia after corneal refractive surgery successfully treated with a corneal rigid gas permeable (RGP) contact lens. Case Presentation: A 30-year-old woman presented with blurred vision and significant glare six months after bilateral refractive lenticule extraction–small incision lenticule extraction (ReLEx SMILE) surgery. The spectacle prescription showed inconsistent results. Corneal topography revealed increased high-order aberration (HOA) with values of 4.470/19.742 in the right eye and 2.543/9.931 in the left eye. After RGP lens fitting, HOA significantly improved to 0.921/1.746 in the right eye and 0.501/0.814 in the left eye, accompanied by marked improvement in subjective visual. However, after three months of follow-up, the patient experienced worsening visual symptoms and topographic findings in the left eye. Conclusions: RGP lenses do not prevent progression but can correct impaired visual function due to ectasia after corneal refractive surgery. Stricter patient selection, including consideration of hormonal factors affecting the eye, is needed to minimize the risk of keratorefractive ectasia.
Co-Authors Agustinus Bimo Gumelar Anak Agung Ayu Putri Prematura Sri Anasary Anak Agung Ayu Sukartini Djelantik Anak Agung Mas Putrawati Triningrat Angelo Doniho Anthea Casey Ari Andayani Cokorda Istri Dewiyani Pemayun Dharmi Lestari, Ni Putu Gde Ngurah Idraguna Pinatih Giovani Faustine Harumi Purwa Prahesthy, Harumi Purwa Hendrawan, Kevin I Gusti Ngurah Agung Trisnu Kamajaya I Putu Budhiastra I Wayan Gede Jayanegara Ida Bagus Putra Manuaba Ivane Jessica Buddyman Juliari, I Gusti Ayu Made Luh Gede Anggasari Dewi Made Agus Kusumadjaja Maharani, Pande Nyoman Anila Putri Ni Made Ari Suryathi Ni Made Ayu Surasmiati Noviantari, I Gusti Agung Ratna PRISCILLA DWIANGGITA Putra Manuaba Putu Adhi Surya Pradana Putu Yuliawati Ratnasari, Ni Luh Made Novi Siska Takarai SUDIBIA, NI KADEK PUSPA MEGA PUTRI Supit, Fabiola Sutyawan, I Wayan Eka Titiek, Ernawati Triningrat, A A Mas Putrawati Triningrat, Anak Agung Mas Putrawati Utari, Ni Made Laksmi WATU, THEDIUS Wedayanti, Pande Made Gita