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Success Rate of Trabeculectomy in Secondary Glaucoma after Vitrectomy in Kariadi Hospital, Semarang, Central Java Farah Maulida; Fifin L. Rahmi; Maharani Cahyono
Majalah Oftalmologi Indonesia Vol 47 No 2 (2021): 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.v47i2.100312

Objectives: Vitrectomy with intravitreal injections of gas or silicone oil is commonly used to treat vitreoretinal diseases such as rhegmatogenous retinal detachment, tractional retinal detachment, and vitreous hemorrhage. Some of these procedure can lead to short-term elevations in intraocular pressure (IOP) and ultimately long-term glaucomatous damage if not treated in a timely manner. Trabeculectomy is a widely performed filtering surgery used in these cases. This study is aimed to define the success rate of trabeculectomy for surgical treatment of secondary glaucoma after vitrectomy in Kariadi Hospital, Semarang, Central Java. Methods: Retrospective study was conducted in secondary glaucoma after vitrectomy patient who underwent trabeculectomy from November 2014-Januari 2019 in Kariadi Hospital. The secondary data of baseline IOP, 1 week, 2 weeks, 1 month, and 3 months after trabeculectomy is obtained from medical records. Results: 19 eyes from 19 patients had mean preoperative IOP 35,56 ± 8,40 mmHg, 1 week 21,01 ± 13,83 mmHg, 2 weeks 26,09 ± 11,27 mmHg, 1 month 29,97 ± 13,45 mmHg, and 3 months 25,47 ± 13,43 mmHg. There was significant differences of IOP level in 1 week, 2 weeks, 3 months (p<0.05), and not significant in 1 month (p 0,171). Complete success rate of trabeculectomy in 1 month was 10,5% and 3 months 10,5%. Qualified success rate in 1 month was 15,8% and 3 months 42,1%. Failed in 1 month was 73,7% and 3 month 47,4%. Conclusions: Trabeculectomy in secondary glaucoma after vitrectomy has low success rate.

Effect of Phacotrabeculectomy on Ocular Biometric, Gonioscopic and Intraocular Pressure In Patients With Primary Angle Closure Glaucoma Riskha Pangestika; Fifin L. Rahmi; Maharani Maharani
Majalah Oftalmologi Indonesia Vol 48 No 1 (2022): 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.v48i1.100496

Objectives: The objective of this study is to have an expanded evaluation on the effect of phacotrabeculectomy on ocular biometric (ACD/anterior chamber depth, lens thickness), gonioscopic and intraocular pressure (IOP) in primary angle closure glaucoma (PACG). Methods: A cohort study of PACG patient who underwent phacotrabeculectomy from September 2018- March 2019 at Dr.Kariadi hospital. Preoperative secondary data of baseline IOP, ACD, lens thickness, and gonioscopy were obtained from medical record. Postoperative primary data of IOP, ACD, and gonioscopy were obtained 2 weeks after surgery. Results: Thirty eyes from 23 patients had preoperative and postoperative mean IOP (26,20±2,24 and 18,35±2,49), mean ACD (2,46±0,37 and 3,40±0,40), mean gonioscopic score (4,97±0,96 and 8,33±1,63), mean preoperative lens thickness (4,58±0,39). There were significant differences between IOP, ACD and gonioscopic score (<0,001) before and after phacotrabeculectomy. The greater lens thickness was associated with IOP reduction ( <0,001 r=0,756), increased ACD ( 0,005 r=0,498), and increased gonioscopic score ( <0,001, r=0,802). The positive correlation can be seen between gonioscopic score and ACD ( <0,001 r=0,666) and the negative correlation between IOP and ACD ( <0,001 r=0.683), IOP and gonioscopic score ( <0,001 r=0,876). Conclusion: Phacotrabeculectomy may be effective in reducing IOP, increasing ACD, and gonioscopic scores significantly in PACG patients. Lens thickness may be positively

TRABECULECTOMY VERSUS TUBE OUTCOME IN NEOVASCULAR GLAUCOMA Syahiqoh, Daisy Syakhsiatusy; Rahmi, Fifin L.; Denti Puspasari; Maharani
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/n4njgr60

Introduction: Neovascular glaucoma (NVG) is known to be a refractory form of glaucoma, which frequently requires the integrated use of medical, laser and incisional surgery. Tube-shunt implantation and trabeculectomy with anti-fibrotic agent are the two most-popular incisional procedures for managing refractory glaucoma. This study aims to compare surgical outcome between patients who underwent trabeculectomy versus tube-shunt implantation for the treatment of NVG. Methods: A retrospective study was held of NVG patients that underwent trabeculectomy and tube-shunt implantation between January 2020 - December 2022 at Dr. Kariadi Hospital, Semarang. IOP outcome and success rate was measured at 3 months post operatively. Statistical analysis was used to compare the outcome between groups, p<0.05 was considered significant. Result: There were no significant differences in characteristics between groups at baseline. Mean IOP measured at 3 months postoperatively was 18.58 ± 5.53 and 15.94 ± 10.79 in trabeculectomy and tube group respectively (p=0.04), complete success rate was 18.8% in trabeculectomy and 25% in tube group, qualified success rate was 37.5% in trabeculectomy and 56.3% in tube group. Greater failure rate was observed in trabeculectomy group (43.8%). Conclusion: Compared to trabeculectomy, tube-shunt implantation has lower IOP at 3 months postoperatively in NVG. Similar number of anti-glaucoma medications was needed postoperatively in both procedure. Greater qualified success rate was achieved in tube-shunt implantation. Greater failure rate was observed in trabeculectomy.

PUPIL CYCLE TIME AND PERIPAPILLARY PERFUSION IN ANGLE CLOSURE GLAUCOMA Kamal, Muhammad Alfin; Rahmi, Fifin L.; Puspasari, Denti; Maharani, Maharani
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/x74s8006

Introduction and Objective: One of important roles in the pathogenesis of glaucoma is vascular condition. To enhance glaucoma management, the clinical assessment of ocular perfusion is required. The pupillary light reflex's afferent or efferent pathways may become impaired as a result of pupil cycle time (PCT) elongation. PCT is a simple objective method to measure the function of optic nerve, including glaucoma. The purpose of this study is to evaluate the connection between pupil PCT and peripapillary perfusion. Methods: A cross-sectional study from Kariadi Hospital included 26 eyes with angle closure glaucoma and 26 eyes of healthy patients. Complete ophthalmologic examinations, PCT measurements, and OCT peripapillary angiography were performed on each patient. Patients with history of drugs use that can affect pupillary reflexes such as barbiturates, methyldopa, anaesthetics, and antidepressant, and patients with history of glaucoma attack are excluded. The comparisons between the two groups were examined, with a p<0.05 indicating statistical significance. Results: The mean PCT of normal subjects was 943,4ms (882,4ms – 993,4ms) and angle closure glaucoma subject was 1789,5ms (1060ms – 4600ms). There were statistically significant difference of PCT value in angle closure glaucoma compared to normal subjects (P<0,05). Peripapillary flow index and peripapillary vessel density in closed angle glaucomatous eyes were lower than normal eyes (P<0.05). There is a significant relationship between PCT with peripapillary flow index and peripapillary vessel density. (P<0,05). Conclusion: In angle closure glaucoma, prolonged PCT associated with decreased peripapillary perfusion as shown by decreases in peripapillary flow index and peripapillary vascular density.

SUCCESSFUL RATE OF GLAUCOMA SURGERY IN SECONDARY GLAUCOMA AFTER VITRECTOMY IN KARIADI HOSPITAL SEMARANG 2020-2022 Ismail, Nur Azizah Intan Putri; Maharani, Maharani; Rahmi, Fifin L.; Puspasari, Denti
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/ja1r1v89

Introduction: Glaucoma is one of the most frequent complications of vitrectomy surgery. It can cause a significant rise in intraocular pressure (IOP). Glaucoma surgery can be planned in medically uncontrolled glaucoma. Trabeculectomy and Glaucoma Drainage Device (GDD) implantation are the most frequent filtering surgeries used in these cases. This study aims to define the success rate of glaucoma surgery in secondary glaucoma after vitrectomy. Methods: This study is an analytical observational study with retrospective data collection held from medical records of patients with secondary glaucoma after vitrectomy who underwent glaucoma surgery in Kariadi General Hospital Semarang from 2020-2022. Surgical success defined by postoperative IOP reduced by>20% from baseline, with or without anti-glaucoma medication. Result: There were 16 eyes of trabeculectomy with 5-fluorouracil (5-FU), and 8 eyes of GDD implants. The mean preoperative IOP was 43.76+6.77 mmhg for trabeculectomy 5-FU, and 42.43+4.02 mmhg for GDD implant. IOP levels in both groups varied significantly after one day, one week, one month, and three months after surgery (p<0.05). The success rate for the trabeculectomy 5-FU group was 75% and the GDD implant group was 87.5% in 3 months. There was no statistically significant difference in the success rate between the trabeculectomy 5-FU and GDD implant groups (p=0.069). The complication were 18.75% and 25% for trabeculectomy group and GDD implant group, respectively. Conclusion: There was no significant difference in the success rate between trabeculectomy 5-FU and the GDD implant group. Both groups are viable for glaucoma surgery in secondary glaucoma after vitrectomy surgery.

EARLY POSTOPERATIVE COMPLICATION FOLLOWING FILTRATION SURGERY IN DR. KARIADI GENERAL HOSPITAL SEMARANG 2020-2022 Mazidah Zulfa, Mazidah Zulfa; Puspasari, Denti; Rahmi, Fifin L.
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: 10.35749/49p4dc89

Introduction and Objective: Filtration surgery is the most frequent surgery in managing glaucoma. Although trabeculectomy is generally a safe and effective procedure, complications can occur. The purpose of the study was to describe the early postoperative complications in patients who had undergone filtration surgery. Methods: This study was a retrospective study that uses secondary data from electronic medical records of patients who had filtration surgery between January 1, 2020, and December 31, 2022, in Kariadi Hospital Semarang. Preoperative data include age, gender, visual acuity, intraocular pressure, and type of glaucoma. The incidence of early postoperative complications was described up to 3 weeks of follow-up. Results: 287 eyes were obtained from 266 patients who underwent filtration surgery. 168 eyes (58.5%) had phaco-trabeculectomy, 117 eyes (40.77%) had trabeculectomy and 2 eyes (0.7%) had ECCE-trabeculectomy. Primary angle closure glaucoma (126 eyes, 43.9%) was the most common type of glaucoma treated with filtration surgery. During the 3-week follow-up period, 93 eyes (32.4%) experienced an early complication with trabeculectomy being more common (17.42%) than combined surgery. The commonest complication found was hypotony in 69 eyes (24%). Other complications include hyphema (3.14%), transient intraocular pressure elevation (3.14%), bleb leakage (2.09%), suprachoroidal haemorrhage (0.7%), subhyaloid haemorrhage (0.35%) and retinal haemorrhage (0.35%). Conclusion: This study found the most common early postoperative complication of filtration surgery was hypotony. This complication occurs frequently after trabeculectomy.

SURGICAL THERAPHY FOR PRIMARY GLAUCOMA IN DR. KARIADI GENERAL HOSPITAL SEMARANG DURING JANUARY 2020 TO DECEMBER 2022: Oral Presentation - Observational Study - Resident Bestari, Zeta Aisyah; Maharani; Puspasari, Denti L.; Rahmi, Fifin L.
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/tcr6p578

Introduction & ObjectivesGlaucoma can be treated with medicamentose, non invasive surgery, and invasive surgery. Thisstudy aim to determine the frequency and type of invasive surgery for primary glaucoma in Dr.Kariadi General Hospital during January 2020 to December 2022. MethodsThis was a descriptive research using secondary data obtained from electronic medical records,consist of gender, age, diagnosis, and type of surgery. The sample were taken with purposivesampling which are fullfill the inclusion criteria. ResultsThere were total of 395 eyes (395 patients) with primary glaucoma who underwent surgery, consistof 33% patients with open angle glaucoma (POAG) and 67% patients with angle closure glaucoma(PACG). Most common surgical theraphy for POAG was trabeculectomy (37%), followed bycombination of trabeculectomy and cataract surgery (32%), cataract surgery (16%),cyclocryotheraphy (10%), implantation of glaucoma drainage device (4%), and goniosynechialysis(1%). For PACG, most often used was combination of trabeculectomy and cataract surgery (61%),cataract surgery (13%), cyclocryotheraphy (12%), trabeculectomy (11%), combination of cataractsurgery and goniosynechialysis (2%), and implantation of glaucoma drainage device (1%). ConclusionThe most common type of surgery was trabeculectomy for primary open angle glaucoma andcombination of trabeculectomy and cataract surgery for primary angle closure glaucoma.

Successful Rate of Glaucoma Surgery in Secondary Glaucoma after Vitrectomy in Kariadi General Hospital Semarang 2020-2022: Oral Presentation - Observational Study - Resident Ismail, Nur Azizah Intan Putri; Maharani; Rahmi, Fifin L.; Puspasari, Denti
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: 10.35749/01mhar90

Introduction & ObjectivesGlaucoma is one of the most frequent complications of vitrectomy surgery. It can cause a significantrise in intraocular pressure (IOP). Glaucoma surgery can be planned in medically uncontrolledglaucoma. Trabeculectomy and Glaucoma Drainage Device (GDD) implantation are the mostfrequent filtering surgeries used in these cases. This study aims to define the success rate ofglaucoma surgery in secondary glaucoma after vitrectomy. MethodsThis study is an analytical observational study with retrospective data collection held from medicalrecords of patients with secondary glaucoma after vitrectomy who underwent glaucoma surgery inKariadi General Hospital Semarang from 2020-2022. Surgical success defined by postoperative IOPreduced by>20% from baseline, with or without anti-glaucoma medication. ResultsThere were 16 eyes of trabeculectomy with 5-fluorouracil (5-FU), and 8 eyes of GDD implants. Themean preoperative IOP was 43.76+6.77 mmhg for trabeculectomy 5-FU, and 42.43+4.02 mmhg forGDD implant. IOP levels in both groups varied significantly after one day, one week, one month, andthree months after surgery (p<0.05). The success rate for the trabeculectomy 5-FU group was81.25% and the GDD implant group was 87.5% in 3 months. There was no statistically significantdifference in the success rate between the trabeculectomy 5-FU and GDD implant groups (p=0.839).The complication for the GDD implant group was 25%. No complications were found in thetrabeculectomy 5-FU group. ConclusionThere was no significant difference in the success rate between trabeculectomy 5-FU and the GDDimplant group. Both groups are viable for glaucoma surgery in secondary glaucoma after vitrectomysurgery.

EFFECT OF “SENAM PERMATA-KU” COMPARED WITH WARM COMPRESS ON THE AMPLITUDE OF ACCOMMODATION IN COMPUTER VISION SYNDROME PATIENTS Setiawan, Teguh; Nugroho, Trilaksana; Dharma, Andhika Guna; Rahmi, Fifin L.; Sadasih, Wisnu
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: 10.35749/425ad398

Introduction and Objective: The COVID-19 pandemic has virtually made many work activities, resulting in increased use of Visual Display Terminals (VDT) at work and home. Excessive close-range activities due to the use of VDT causes Computer Vision Syndrome (CVS). Various therapies, such as ocular yoga and warm compress, have been created to reduce CVS-related complaints. Diponegoro University developed “Senam PERMATA-KU” as an alternative therapy to reduce complaints related to CVS. This study compares the effect of “Senam PERMATA-KU” and periocular warm compress on the amplitude of accommodation (AA) value in patients with CVS. Methods: The study subjects were divided into “Senam PERMATA-KU” group (22 people) and periocular warm compress group (20 people) with each treatment for two weeks. CVS score was measured using CVS-Questionnaire and AA using Prince’s rule. Both variables were assessed before and after treatment. Data were collected and analyzed using a statistical computer program. Result: “Senam PERMATA-KU” group experienced a significant increase in monocular and binocular AA (p<0.001 and p=0.006), while periocular warm compress did not show a significant difference (p=0.982 and p=0.483). The mean delta of monocular and binocular AA between groups differed significantly (p=0.001 and p=0.034). The mean CVS scores in both groups have significant improvement (p<0.001), while the mean delta CVS scores between groups was not significant (p=0.522). Conclusion: “Senam PERMATA-KU” for two weeks significantly increased monocular and binocular AA, while periocular warm compress showed no significant difference. “Senam PERMATA-KU” and periocular warm compress can significantly reduce CVS score, whereas the difference between the two is insignificant.

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