Irawati, Yunia
Department Of Ophthalmology, Faculty Of Medicine, Universitas Indonesia, Cipto Mangunkusumo Kirana Hospital, Jakarta

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Management of old naso-orbital fractures with ocular involvement and associated complications caused by facial trauma Arianti, Alia; Irawati, Yunia
Medical Journal of Indonesia Vol 27, No 1 (2018): March
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (949.486 KB) | DOI: 10.13181/mji.v27i1.1959

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A 14-years-old boy came with chief complaint of epiphora and history of globe rupture repair surgery due to facial trauma one year ago. Patient got complications from the trauma, including nasolacrimal duct obstruction, phthisis bulbi, enophthalmos, facial deformities, and ptosis. Multidisciplinary approach was performed simultaneously in one session surgery which included oral mucosal graft for non-irritative phthisis bulbi, silicone block implant for blowout fracture, external dacrycystorhinostomy for obstructed nasolacrimal duct, fascia lata brow suspension/frontalis sling for ptosis, and septorhinoplasty for nasal augmentation. After the surgery, symptoms of epiphora had resolved and aesthetical improvement of facial deformities was also prominent. Management of old orbital fracture poses additional challenges due to the complications that have occurred over time. Loss of functionality may seem impractical to manage because no function can be pertained. Nevertheless, it is important to still perform surgical repair for aesthetic purposes due to the psychological effect on their daily lives.
HEALTH CARE SERVICE FOR LEPROSY PATIENTS IN SITANALA TANGERANG (A PROPOSED APPROACH OF COMPREHENSIVE HEALTH CARE FOR LEPROSY PATIENT) Irawati, Yunia; Lestari, Yeni Dwi; Bani, Anna Puspitasari; Menaldi, Sri Linuwih; Wahyuni, Luh Karunia; Kurniawardhani, Dewinta Retno
ASEAN Journal of Community Engagement Vol. 2 No. 2 (2018)
Publisher : UI Scholars Hub

Show Abstract | Download Original | Original Source | Check in Google Scholar

Abstract

Based on WHO data, Indonesia has the third largest leprosy burden in the world, afterIndia and Brazil. Although leprosy was declared to be eliminated in severalprovinces, there are still several leprosy settlements spread in Indonesia. Oneof these settlements is Neglasari village in Tangerang City, West Java, whereleprosy patients have been living since 1981. There is a scarcity ofinformation regarding the features of leprosy in Indonesia, especially aboutthe description of the patients’ posttreatment condition in terms of bothclinical sequelae and health services provided. A collaboration betweenmultiple departments of Ophthalmology, Dermatovenereology, and MedicalRehabilitation from the Cipto Mangunkusumo Hospital/Universitas Indonesia,Jakarta, was established in the form of a health service program to determinethe number and features of disabilities of ex-leprosy patients. We providehealth services, including physical examinations, extend free medication andeye glasses, and impart knowledge about the chronic complications to patientsand local cadres. A nonroutine health service program for leprosy patients wasconducted in Neglasari village, which performed four primary activities ofpromotive, preventive, curative, and rehabilitative. The program included atotal of 260 patients, with a mean age of 50.45 ± 10.15 years and most of thembeing males (60.4%). A duration of >5 years of leprosy was found in 47% ofsubjects, and 96% of them have been released from treatment. Disabilitiescomprised 52.5% in the eye, 87.7% in the hand, and 92% in the foot. In total,65% of the patients had an uncorrected visual acuity of normal to mildimpairment, whereas 5.8% were blind. Eye abnormalities included madarosis(43.9%), entropion (41%), cataract (26%), corneal hypoesthesia (20.6%),trichiasis (17.8%), and lagophthalmos (15.1%), and examination of theextremities revealed that 16% of the subjects had an amputated foot. Spectacleswere successfully distributed to 100% of patients who were visually correctable.This proposed model for leprosy health care program involving multidisciplinaryexpertise is effective for screening numerous disabilities in leprosy patientsat one time. This enables caretakers to determine a holistic management that atthe end is intended to improve the quality of life of patients.
Endoscopic dacryocystorhinostomy as an option management of syndrome- related congenital dacryocystocele: a case report Yunia Irawati; Alexander Krishna Ernanda; Florentina Priscilia; Retno Sulistyo Wardani
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 53, No 4 (2021)
Publisher : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.19106/JMedSci005304202110

Abstract

Congenital dacryocystocele (CD) is a rare anomaly of the medial region of the orbit, caused by distal at the level of the valve of Hasner and proximal at the level of the valve of Rosenmuller obstruction of the lacrimal system. It may present as isolated abnormalities or maybe associated with syndromes. We described a neonate with a history of bilateral enlarged lacrimal sacs below medial canthal tendon with blue-grayish color and epiphora.  Computed tomography (CT) scan resulted in congenital dacryocystocele. She was given topical antibiotics and Crigler massage as conservative treatment. In the first week, the right eye got a complete resolution. Otherwise, the left eye’s lesion was worsening. The patient underwent endoscopic dacryocystorhinostomy (En-DCR) and silicone intubation on the left eye. Epiphora resolved with no recurrence at one month follow up. Conservative treatment and En-DCR have a success rate with no complication and widely used nowadays. In the case of CD associated with a syndrome, multidiscipline workups and treatment are essential.
Rekonstruksi deformitas malar pada fraktur lama multipel wajah menggunakan kartilago iga dan silikon Dini Widiarni; Arroyan Wardhana; Endang Mangunkusumo; Yunia Irawati
Oto Rhino Laryngologica Indonesiana Vol 40, No 2 (2010): Volume 40, No. 2 July - December 2010
Publisher : PERHATI-KL

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32637/orli.v40i2.2

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Background: In old traumatic multiple facial fractures, connective tissue and fibrosis were formedwhich make them difficult to be repaired. Purpose: To illustrate to ENT- Head and Neck surgeons asreconstructive surgery could restore the aesthetic and function in facial deformity. Case: Two cases ofold multiple facial fracture were reported. One case was a 32 years old man with history of falling froma tree three years ago and second case was 41 years old man with history of car accident two years ago.   Case management: Those two cases were managed with facial reconstruction and malar augmentation using rib cartilage, plate and screw andsilicon implant. Conclusion: Facial reconstruction using rib cartilage autograft, plate and screw or silicon implant could be repair malar asymmetry. Facial analysisin facial reconstruction is important in determining the site of implantation precisely.Keywords: old multiple facial fracture, facial reconstruction, rib cartilage autograft, silicone implant. Abstrak : Latar belakang: Fraktur multipel wajah akibat trauma lama, telah membentuk jaringan ikatdan fibrosis sehingga sukar untuk dilakukan perbaikan. Tujuan:  sebagai ilustrasi untuk ahli THT-KL,bagaimana bedah rekonstruksi dapat memperbaiki estetika dan fungsi pada deformitas wajah.Kasus:Dua kasus fraktur lama wajah yaitu, pertama laki-laki berusia 32 tahun dengan riwayat jatuh dari pohon 3 tahun yang lalu dan kasus kedua laki-laki berusia 41 tahun dengan riwayat kecelakaan lalu lintas 2tahun yang lalu.Penatalaksanaan: Pada kedua pasien dilakukan rekonstruksi wajah dengan augmentasimalar menggunakan kartilago iga,plate and screw dan implan silikon. Kesimpulan: Rekonstruksiwajah menggunakan tandur autologus kartilago iga dan plate and screw atau implan silikon dapatmengurangi asimetri malar. Analisis wajah pada saat rekonstruksi penting untuk menentukan posisitandur atau implan dengan tepat.Kata kunci: fraktur multipel lama wajah, rekonstruksi wajah, tandur autologus kartilago iga, implansilikon.
Screening Kesehatan Mata Anak pada Komunitas Kusta dalam Era Pandemi Covid-19 Yunia Irawati; Julie Dewi Barliana; Hindun Zakiyah; Hisar Daniel; Made Susiyanti
Media Karya Kesehatan Vol 5, No 1 (2022): Media Karya Kesehatan
Publisher : Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24198/mkk.v5i1.33560

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Indonesia masih merupakan negara endemis kusta terbanyak ketiga didunia. Tim KATAMATAKU telah melakukan program kesehatan pada penderita kusta dan komunitasnya selama tiga tahun terakhir. Sebagai generasi penerus bangsa, kesehatan mata anak di lingkungan tersebut perlu diperhatikan. Deteksi gangguan mata anak dan tatalaksananya harus sedini mungkin dilakukan. Pandemi Covid-19 di Indonesia berdampak pada banyak aspek. Pembelajaran dengan system daring/online membuat anak menatap layar digital lebih lama sedangkan kegiatan diluar rumah dibatasi, hal ini meningkatkan gangguan penglihatan. Pemeriksaan kesehatan mata anak di Indonesia masih jarang dilakukan secara rutin. Tujuan dari pengabdian masyarakat ini adalah untuk mendeteksi gangguan mata pada anak di lingkungan sosio-ekonomi rendah, komunitas kusta, Tangerang saat pandemi covid 19. Metode pelaksanaan kegiatan dengan penelusuran riwayat kesehatan, pemeriksaan ketajaman visual dengan chart dan autorefraktometri, segmen anterior, dan segmen posterior. Pemeriksaan dilaksanakan 12-13 Desember 2020 melibatkan total 103 anak dengan median usia 11 (4 - 18) tahun. Rasio laki-laki dan perempuan adalah 1: 1,2. Mayoritas anak yang terpapar digital screen time lebih dari 2 jam perhari sebesar (80/103, 77.7%) dengan (11/103, 10.7%) anak mengalami gangguan refraksi.  Waktu menatap layar gadget yang lama, seringnya melihat dalam jarak dekat dan kegiatan diluar ruangan yang kurang, dapat berpotensi meningkatkan progresivitas gangguan refraksi. Meskipun dengan banyak keterbatasan karena pandemi, screening kesehatan mata anak tetap perlu dilakukan dengan melakukan modifikasi kegiatan sesuai protokol kesehatan. Kegiatan ini diharapkan dapat meningkatkan pemahaman anak dan orang tua terkait pentingnya pemeriksaan mata pada anak secara rutin sejak dini dan dapat menjadi contoh pelaksanaan skrining kesehatan di masa pandemi. Kata kunci: COVID-19, daring, digital screen time, tajam penglihatan
Posterior Segment Pathologies in Leprosy Patients with Visual Impairment: A Case Series Gitalisa Andayani Adriono; Andi Marsa Nadhira; King Hans Kurnia; Yunia Irawati
eJournal Kedokteran Indonesia Vol 10, No. 1 - April 2022
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (312.241 KB) | DOI: 10.23886/ejki.10.12.71-6

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Leprosy is an important infectious disease, which is still prevalent in developing countries including  Indonesia. This disease may affect the skin, extremities, peripheral nerves, and the eyes, causing disabilities of the patient. Leprosy is known to cause various ocular disorders, however, posterior segment abnormalities which involve the retina, choroid dan vitreous, have rarely been reported. Therefore, we present a case series of patients with posterior segment pathologies in visually impaired leprosy patients. These patients were identified during a community-based screening program on 99 leprosy patients, held in July 2019 in Alverno Hospital, Singkawang West Kalimantan. Patient comprised of inpatients and former patients who lived within the city and nearby cities who were invited for the program. All patients underwent comprehensive ophthalmology examination, performed by general ophthalmologists. Visual impairment was found in 15 patients, and their pupils were dilated, followed with posterior segment examination with indirect ophthalmoscopy and fundus photograph, using a handheld fundus camera, done by a vitreoretina specialist. Out of all patients screened, we did not find any leprosy-related posterior segment abnormalities. However, posterior segment pathologies were found in six patients, including peripapillary atrophy, myopic crescent, drusen and chorioretinal atrophy. One patient showed extensive chorioretinal atrophy with pigment clumping, which may be caused by leprosy- related chronic inflammatory process.  
Challenges in Managing Eyelid Basal Cell Carcinoma with Mohs Surgery and Close the Large Eyelid Defect after Tumor Removal Rio Rhendy; Yunia Irawati; Adhimukti Sampurna
Majalah Oftalmologi Indonesia Vol 41 No 1 (2015): 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.v41i1.4

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Background: Basal cell carcinoma (BCC) is the most common skin cancer of the eyelid. The important things management we have to emphasize are to prevent recurrence rate and to get the good cosmetic result after reconstruct the large defect. The aim of this case report is to show the management of both eyelid basal cell carcinoma and large eyelid defect after tumor removal.Methods: Case Report. A Woman 40 years old was reffered from Dermatovenereology Department of Cipto Mangunkusumo Hospital with aggressive type BCC. The location of the tumor was at inferior left eyelid with size of 18 x 19 mm. They planned to perform Mohs’ surgery and consulted to Plastic and Reconstruction division of Ophthalmology Department for eyelid reconstruction. After Mohs’ surgery the horizontal length of the eyelid defect was more than 50% and vertical defect was more than 15 mm. The Mustarde cheek advancement flap were choosen.Results: Post operation necrotic tissue was noted do to ischemic problem. Oral corticosteroid was given with tapering dose for six days. One month later, the condition was improved and Dermatovenereology department performed diode laser for the necrotic tissue and further showing good result.Conclusion: The management for eyelid BCC were still challenging including the technique to reconstruct the large eyelid defect, the risk of recurrence after the tumor removal and post operative result. The dicision to choose the proper technique to reconstruct the eyelid defect and tight follow-up after surgery will give optimal functional and cosmetic result. Keywords: basal cell carcinoma; Mohs surgery; Mustarde cheek advancement flap; necrotizing flap; corticosteroid; diode laser
A Five-Year Study of Cicatricial Entropion at Kirana Eye Hospital: Clinical Characteristics and Surgical Outcomes Yunia Irawati; Bachtiar Wicaksono; Carennia Paramita
Majalah Oftalmologi Indonesia Vol 47 No 1 (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.v47i1.100161

Abstract

Purpose: Cicatricial entropion is an inward turning of eyelid margin caused by scarring tissue of the posterior lamella. The chronic damage of cicatricial entropion can irritate the ocular surface and harm the cornea. Proper reconstructive surgery techniques are needed to prevent further damage and visual impairment. This retrospective study was done to evaluate the clinical characteristics of cicatricial entropion and surgical outcomes to repair entropion at Kirana Eye Hospital, dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia. Methods: Records of all patients with cicatricial entropion who underwent surgical repair between January 2012 and December 2017 were reviewed retrospectively. Variables include basic and clinical characteristics, and surgical outcomes were recorded and analysed. Results: A hundred and twenty-two eyelids from 79 patients were included. Of those patients, 57% were female with mean age 51.4 years old. The laterality tendency is bilateral in 43 patients (54.4%). The most common initial complaints were foreign body sensation (35.4%). Cicatricial entropion is most commonly found on the upper eyelid (97.5%) with moderate severity. The majority of etiology is unknown but referred to chronic ocular surface inflammation in 51 eyelids (64.6%). Combined procedures were performed in most of the eyelids (79.5%). Conclusion: It is imperative that combined procedures be carried out in a moderate-severe degree cicatricial entropion. In our current study, recurrence mostly happen in patients suffering from Stevens-Johnson syndrome.
Editor's Word Widya Artini Wiyogo; Yunia Irawati
Majalah Oftalmologi Indonesia Vol 48 No 2 (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.v48i2.100662

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Management of Full-Thickness Lower Eyelid Defect After MOHS Procedure and Mustard Flap: Poster Presentation - Case Report - Ophthalmologist SRI IRMANDHA KUSUMAWADHANI; HISAR DANIEL; YUNIA 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: 10.35749/1y1njp48

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Introduction : Large full-thickness eyelid defects are considered a challenging case. This study reports how to manage the reconstruction of eyelid defect in a case with a history of carcinoma cell basal of the eyelid, which is removed with MOHS procedure and mustard flap reconstruction but full-thickness of more than 50% defect of the lower eyelid remains. Case Illustration : A 67 years old woman was referred from the dermatology and venereology clinic with a history of eyelid cancer operation, 13 days prior. The patient's chief complaint was the left lower eyelid felt pulled down. Examination revealed a left lower eyelid full-thickness defect of more than 50% and ectropion at the lateral side. An 8 mm lagophthalmos without corneal exposure was present. The reconstruction was done with a lips mucosa graft to form posterior lamella, at the medial side anterior lamella was formed by the glabellar flap, and at the lateral side was formed by a skin graft due to lack of the anterior lamella from the mustard flap previously. Discussion : Eyelid reconstruction aims to provide adequate globe protection. The principle management of reconstruction in full-thickness eyelid defects horizontally of more than 50% can’t be done by an anterior flap (mustard) only because it's unstable and the eyelid can be retracted. The reconstruction must consist of the anterior and posterior lamella which have to be tight to the periosteum. Conclusion : One step procedure for large defects of the lower eyelid after cancer removal can be done with considering the proper plan of reconstruction technique.