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All Journal Sriwijaya Journal of Ophthalmology Archives of The Medicine and Case Reports
Indira Putri
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Biochemistry, Genetics & Molecular Biology Health Professions Medicine & Pharmacology Nursing Public Health

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Refractive Error Correction in Bali, Indonesia: A Retrospective Cohort Study of ReLEx SMILE and Femto-LASIK Outcomes Semara Budiyasa; Indira Putri
Sriwijaya Journal of Ophthalmology Vol. 7 No. 2 (2024): Sriwijaya Journal of Ophthalmology
Publisher : Department of Opthalmology, Faculty of Medicine, Universitas Sriwijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/sjo.v7i2.122

Abstract

Introduction: Technological advances have driven progress in surgical techniques for refractive problems, including the use of laser-assisted in situ keratomileusis (LASIK) through the ReLEx SMILE and Femto-LASIK methods. While Bali Mandara Eye Hospital pioneered LASIK procedures in Bali Province, there has been no research to date evaluating the outcomes of these procedures. Methods: This retrospective cohort study analyzed medical record data from patients with refractive disorders who underwent LASIK surgery at Bali Mandara Eye Hospital between January and December 2023. The data collected included patient demographics, pre-and post-operative visual acuity, and the type of LASIK surgery performed. Results: The study included 151 eyes. The majority of patients were male (52.3%), aged 17-29 years, had a college education (60.3%), worked in the private sector (38%), resided in Bali (86%), and underwent the ReLEx SMILE procedure (60.3%). Both Femto-LASIK and ReLEx SMILE procedures yielded excellent visual outcomes and were considered safe. Post-operative uncorrected visual acuity (UCVA) improved to the level of pre-operative best-corrected visual acuity (BCVA) in 137 eyes (90.73%). Conclusion: The ReLEx SMILE and Femto-LASIK methods are both safe and effective procedures for correcting refractive errors, particularly mild myopia. There was no significant difference in visual outcomes between the two methods.
Predicting Glaucoma Progression with Artificial Intelligence: A Meta-Analysis of Machine Learning Models Indira Putri
Sriwijaya Journal of Ophthalmology Vol. 7 No. 2 (2024): Sriwijaya Journal of Ophthalmology
Publisher : Department of Opthalmology, Faculty of Medicine, Universitas Sriwijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/sjo.v7i2.124

Abstract

Introduction: Glaucoma, a leading cause of irreversible blindness, requires early detection and prediction of progression to preserve vision. Artificial intelligence (AI) offers promising tools for analyzing complex ophthalmic data and identifying high-risk individuals. This meta-analysis evaluates the performance of machine learning (ML) models in predicting glaucoma progression. Methods: A systematic search of PubMed, Scopus, and Web of Science databases was conducted for studies published between 2013 and 2024 that investigated the use of ML models to predict glaucoma progression. Studies reporting performance metrics like sensitivity, specificity, area under the receiver operating characteristic curve (AUC), and accuracy were included. Results: Six studies met the inclusion criteria, encompassing 1,250 participants. The pooled sensitivity and specificity of ML models for predicting glaucoma progression were 0.81 (95% CI: 0.78-0.84) and 0.77 (95% CI: 0.73-0.81), respectively. The pooled AUC was 0.88 (95% CI: 0.86-0.90), indicating excellent discriminatory ability. Conclusion: ML models hold significant potential for predicting glaucoma progression with high accuracy. Further research with larger, more diverse datasets is needed to validate these findings and develop clinically applicable tools.
Smoking-Related Tear Film Abnormalities and Dry Eye Disease: A Meta-Analysis Indira Putri
Archives of The Medicine and Case Reports Vol. 6 No. 1 (2025): Archives of The Medicine and Case Reports
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/amcr.v6i1.667

Abstract

Dry eye disease (DED) is a prevalent ocular condition characterized by tear film instability and ocular surface inflammation. Smoking has been identified as a potential risk factor for DED, but the impact of different smoking modalities (active, passive, and e-cigarette) on tear film and DED remains unclear. This meta-analysis aimed to evaluate the association between various forms of smoking and tear film abnormalities leading to DED. A systematic search of PubMed, Embase, and Cochrane Library databases was conducted for studies published between 2013 and 2024 investigating the effects of active smoking, passive smoking, and e-cigarette use on tear film parameters and DED diagnosis. Data extracted included tear film break-up time (TBUT), Schirmer's test results, tear osmolarity, and DED diagnostic criteria. Pooled effect estimates were calculated using random-effects models. Eight studies met the inclusion criteria, comprising 4 on active smoking, 2 on passive smoking, and 2 on e-cigarette use. Active smoking was significantly associated with reduced TBUT (standardized mean difference [SMD] = -2.87; 95% CI: -3.12 to -2.62; p<0.00001), lower Schirmer's test scores (SMD = -2.79; 95% CI: -3.23 to -2.35; p<0.00001), and increased tear osmolarity (SMD = 12.55; 95% CI: 8.17 to 16.93; p<0.00001). Passive smoking and e-cigarettes showed a similar trend but with less pronounced effects. In conclusion, this meta-analysis provides evidence that active smoking significantly impairs tear film stability and contributes to DED. Passive smoking may also have detrimental effects, while the impact of e-cigarettes requires further investigation. These findings underscore the importance of smoking cessation in DED management and public health strategies for eye health.
Dissociated Therapeutic Regimen: Systemic Corticosteroids and Topical Natamycin in Traumatic Fungal Keratitis Cyntia Dewi; Indira Putri
Sriwijaya Journal of Ophthalmology Vol. 8 No. 1 (2025): Sriwijaya Journal of Ophthalmology
Publisher : Department of Opthalmology, Faculty of Medicine, Universitas Sriwijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/sjo.v8i1.132

Abstract

Introduction: Penetrating ocular trauma complicated by secondary fungal keratitis presents a fundamental inflammatory paradox in ophthalmology. While corticosteroids are clinically imperative to suppress trauma-induced fibrinoid syndrome and prevent phthisis bulbi, they are traditionally contraindicated in active mycotic infections due to the risk of potentiating fungal proliferation. This report evaluates a dissociated therapeutic protocol utilizing systemic corticosteroids alongside topical antifungals to navigate this therapeutic impasse. Case presentation: We present the case of a 26-year-old male sustaining a penetrating corneal injury from a metallic nail. Following primary repair, the patient developed a severe anterior chamber reaction with Standardization of Uveitis Nomenclature (SUN) Grade 3+ cells and a corneal infiltrate exhibiting feathery margins. Potassium Hydroxide 10% wet mount confirmed the presence of fungal hyphae. A dissociated therapeutic regimen was initiated: intensive topical Natamycin 5% administered hourly to target the ocular surface infection, synchronized with oral Methylprednisolone (24 mg/day; 0.4 mg/kg) to control intraocular inflammation via the systemic circulation. The regimen successfully decoupled the immune response. Intraocular inflammation resolved within 14 days, preventing the formation of permanent synechiae or cyclitic membranes. The fungal infection was eradicated, confirmed by negative serial corneal smears and the clinical resolution of the infiltrate into a stable leucoma. Visual acuity improved from Hand Motion (LogMAR 2.30) at presentation to 6/45 (LogMAR 0.88) at Day 35. No fungal recurrence was observed during the follow-up period. Conclusion: A dissociated strategy using intermediate-dose systemic corticosteroids to manage internal inflammation, while reserving the ocular surface for aggressive topical antifungal therapy, may offer a viable strategy for globe salvage in complex traumatic fungal keratitis cases where standard protocols are undefined.
Co-Authors Cyntia Dewi Semara Budiyasa