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Riskha Pangestika
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Health Professions Medicine & Pharmacology Public Health

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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

Abstract

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
Successful Management of Cataract in Patient With Long Anterior Zonules and Small Pupil :A Rare Case: Poster Presentation - Case Report - Ophthalmologist Riskha Pangestika; Rio Rhendy; Syska Widyawati
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/e9shxj46

Abstract

Introduction : Long anterior zonules (LAZ) are rare disease with prevalence was 1–2%, characterized by zonular fibers that extend centrally leading to a small zonule-free zone (ZFZ), which raises the risk of complications during zonular cutting while continuous curvilinear capsulorhexis (CCC). This leads to two options whether to perform phacoemulsification through a small CCC within the small ZFZ or an adequately sized CCC. The objective of this study was to report challenging management of phacoemulsification surgery with LAZ eyes with small pupil Case Illustration : A 62 y.o female had visual acuity(VA) 0.7(logMAR) due to corticonuclear cataract in left eye. She had history complicated cataract surgery with secondary sulcus fixated IOL in her fellow eye. The IOP was normal, no phacodenesis and pseudoexfoliative material observed in left eye. The posterior segment was normal. The left eye observed otherwise normal in initial examination. Intraoperatively, after viscomidriasis technique the ZFZ identified in the area of 2.0-2.5 mm from central. Five millimeter CCC can be achieved in the central area and phacoemulsification with the help of CTR (Capsular Tension Ring) safely performed and one piece IOL was implanted in the bag. Discussion : On the first postoperative day, VA was improves to 0.4(logMAR), IOL central and clear corneal with minimal inflammation. One week after surgery, the VA 0.3(logMAR) and no sign of IOL decenteration. Conclusion : Phacoemulsification in eyes with LAZs can be safely performed with CTR through an adequately sized CCC without significant complications. A combination of early recognising high-risk eye, proficient skills, and surgical instruments can improve outcome.
Co-Authors Fifin L. Rahmi Maharani Maharani Rio Rhendy Syska Widyawati