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AKURASI BIOMETRI IMERSI PADA OPERASI KATARAK DI POLIKLINIK MATA RSD MANGUSADA BADUNG TAHUN 2022 Natan, Priscilla Christina; Triharpini, Ni Nyoman; Sucicahyati, Deasy
E-Jurnal Medika Udayana Vol 12 No 6 (2023): E-Jurnal Medika Udayana
Publisher : Universitas Udayana

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24843/MU.2023.V12.i06.P06

Pendahuluan: Keakuratan refraksi dan penglihatan bebas kacamata adalah tuntutan pasien zaman sekarang. Untuk mencapai akurasi refraktif pasca operasi, perhitungan biometri dan kekuatan lensa intraokular (IOL) yang tepat sangat penting. Untuk menghitung kekuatan IOL dan menentukan penempatan lensa efektif pasca operasi, diperlukan data biometri. Di Rumah Sakit Daerah Mangusada, metode biometri imersi paling sering diterapkan. Tujuan dari penelitian ini adalah untuk mengetahui keakuratan perhitungan kekuatan IOL pada mata yang menjalani operasi katarak fakoemulsifikasi dan operasi katarak insisi kecil (SICS) dengan implantasi IOL menggunakan biometri ultrasonografi A-scan imersi melalui evaluasi mean absolute refraction error. Metode: Studi deskriptif retrospektif ini mengumpulkan data dari rekam medis pasien yang menjalani fakoemulsifikasi dan SICS dengan implantasi IOL yang diukur dengan USG biometri imersi, menentukan panjang aksial (AL), K rata-rata, kedalaman ruang anterior (ACD), ketebalan lensa, perhitungan daya IOL menggunakan rumus Holladay, dan prediktabilitas target refraksi pasca operasi oleh perangkat biometri. Hasil refraksi, karakteristik subjek, dan variabel yang memengaruhi akurasi biometri dinilai. Hasil: Penelitian ini mengumpulkan sebanyak 45 mata dari 41 pasien yang dievaluasi. Akurasi biometri ultrasonografi imersi pada penelitian ini adalah 62,2% pada rentang <0,25D. Estimasi hasil refraksi memiliki korelasi positif dengan spherical equivalent pasca operasi. Kesimpulan: Dalam penelitian ini, akurasi biometri ultrasonografi imersi terbilang cukup baik, namun untuk meningkatkan keakuratan hasil operasi katarak pasca operasi, operator biometri perlu mendapatkan pendidikan yang menyeluruh karena mesin biometri memerlukan kalibrasi rutin. Kata Kunci: Biometri Imersi, Bedah Katarak, Kelainan Refraksi

TRAUMA KIMIA MATA YANG DISEBABKAN POTASSIUM PERMANGANAT (KMNO4) Amajida, Saraya; Ayu, Niluh Putu; Octaviany, Efi; Natan, Priscilla Christina
Oftalmologi : Jurnal Kesehatan Mata Indonesia Vol 5 No 3 (2023): Jurnal Oftalmologi Edisi Desember 2023
Publisher : Pusat Mata Nasional Rumah Sakit Mata Cicendo Bandung

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.11594/ojkmi.v5i3.58

Pendahuluan: Trauma kimia mata adalah kegawatdaruratan yang sering pada anak-anak. Trauma mata disebabkan oleh senyawa asam maupun basa. Salah satu penyebab trauma kimia pada mata yang jarang ditemui adalah Potassium Permanganat (KMnO4). Laporan kasus ini bertujuan untuk mendeskripsikan tatalaksana trauma kimia mata yang disebabkan Potassium Permanganat di PMN RS Mata Cicendo Bandung. Laporan Kasus: Seorang anak laki-laki berusia 3 tahun datang ke Instalasi Gawat Darurat (IGD) Rumah Sakit Mata Cicendo dengan keluhan nyeri, merah dan bengkak pada mata kiri. Pasien terkena cairan KMNO4 ketika sedang bermain 10 jam sebelum masuk ke rumah sakit. Pemeriksaan visus pada mata kanan 6/6 sedangkan mata kiri sulit untuk diperiksa. Terdapat bengkak pada kelopak mata atas dan bawah, senyawa KMnO4 melekat kuat pada konjungtiva tarsal dan konjungtiva bulbi. Kornea keruh dan tes bayangan positif. Diskusi: Pasien didiagnosa dengan Trauma Kimia Ropper Hall derajat II OS. Pasien diirigasi dengan 2 liter cairan salin normal sampai mencapai pH 7. Pasien dilakukan transplantasi membran amnion dan debridemen permukaan mata dalam anestesi. Tatalaksana fase awal kasus ini adalah irigasi. Terapi definitif memerlukan pembedahan untuk mempercepat proses penyembuhan. Komplikasi yang sering terjadi adalah defisiensi sel limbus kornea, mata kering, simblepharon, glaukoma sekunder, dan katarak. Kesimpulan: Penanganan yang cepat dan agresif diperlukan dalam kasus-kasus seperti ini untuk untuk mendapatkan penyembuhan yang lebih baik.

TRABECULECTOMY IN CLOSED ANGLE UVEITIS GLAUCOMA A CASE REPORT: Poster Presentation - Case Report - Ophthalmologist SAMOSIR, ALEXANDER THEODORE; NATAN, PRISCILLA CHRISTINA
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/wwarcp46

Introduction : Glaucoma uveitis is caused by increased outflow resistance, which distorts the balance between water production and outflow. Trabeculectomy is better than LPI in controlling IOP in glaucoma uveitis Case Illustration : Male patient aged 45 years, came to the Eye Polyclinic at Serui Hospital with complaints of very painful right eye since 2 weeks ago, the patient also complained of being unable to see at all, red eyes, headache, stiff neck, nausea and vomiting. Ophthalmological examination reveal right eye vision no light perception (NLP), palpebral edema, spasm, conjunctival hyperemia, corneal edema, shallow anterior chamber angle, iris-corneal contact, negative pupillary reflex, total pupillary block, negative fundus reflex, schiotz IOP 81 mmHg. Discussion : The patient diagnosed as right eye acute glaucoma and treated with acetazolamide, timolol maleate eye drops, potassium aspar tablets, prednisolone acetate drops, diclofenac sodium drops in the right eye, paracetamol tablets, re-evaluate in 2 hours. The patient chose to be referred to a hospital in Surabaya. The patient came back with the same complaint and was treated the same as before, right eye surgery trabeculectomy + peripheral iridectomy with releaseable suture flap limbal base with controlled IOP results, releaseable suture sutures were removed in 2 weeks. Trabeculectomy of the uveitic eye is generally less successful because of accelerated wound healing by the postoperative fibrinous and cellular response. Antimetabolites such as 5FU and Mitomycin C are used to enhance the success of trabeculectomy in uveitis eyes (5FU, MMC). 95% success (IOP less than 21 mm Hg with 1 or no treatment) was achieved with MMC augmented trabeculectomy. Conclusion : Increased IOP due to pupillary block causes acute glaucoma with signs of high IOP, middilated pupils, decreased pupillary reflexes, and irregular shape, corneal epithelial edema, episcleral and conjunctival vascular congestion, shallow anterior chamber, small number of flares and cells.

Ab-Interno Bleb Needling in A Failed Trabeculectomy: A Case Report: Poster Presentation - Case Report - General practitioner Natan, Priscilla Christina; Yinvill; Rahayu, Ni Kompyang; Wetarini, Krisnhaliani
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/pcxffx48

Introduction : Trabeculectomy remains a gold standard of glaucoma surgical management despite a steady rate of bleb failure due to conjunctival scarring. In this case, we report a case of a failed trabeculectomy managed with ab-interno bleb needling followed by antimetabolite injection of mitomycin C. Case Illustration : A 18-year-old male patient with a history of blurry vision in his right eye and vision loss in his left eye. The patient had previously undergone cataract surgery due to juvenile cataracts and developed persistent high intraocular pressure (IOP) in both of his eyes. A trabeculectomy was performed on his right eye six months prior to the examination; however, the IOP remained at 22 mmHg. Ocular examination revealed a shallow anterior chamber and flat conjunctival bleb. An ab-interno bleb needling technique was performed followed by antimetabolite injection of mitomycin C under local anesthesia in an operating theatre. Follow-up results showed a significant reduction of IOP on the first day (13.3 mmHg) and a week after surgery (18.5 mmHg), maintained by one anti-glaucoma eye drop. Discussion : Trabeculectomy filtration surgery has a high failure rate in younger patients due to a high risk of conjunctival scarring. The ab-interno needling approach with mitomycin C injection is a novel technique that can be performed and offers the advantage of increasing aqueous outflow through a direct opening of the trabecular meshwork from within the anterior chamber. Conclusion : This technique provides effective management of failed trabeculectomy to achieve intraocular pressure lowering effect and a corresponding decrease in the risk of progressive glaucomatous optic neuropathy.

TRABECULECTOMY IN CLOSED ANGLE UVEITIS GLAUCOMA A CASE REPORT: Poster Presentation - Case Report - Ophthalmologist Samosir, Alexander Theodore; Natan, Priscilla Christina
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/p8vwdw41

Introduction : Glaucoma uveitis is caused by increased outflow resistance, which distorts the balance between water production and outflow. Trabeculectomy is better than LPI in controlling IOP in glaucoma uveitis Case Illustration : Male patient aged 45 years, came to the Eye Polyclinic at Serui Hospital with complaints of very painful right eye since 2 weeks ago, the patient also complained of being unable to see at all, red eyes, headache, stiff neck, nausea and vomiting. Ophthalmological examination reveal right eye vision no light perception (NLP), palpebral edema, spasm, conjunctival hyperemia, corneal edema, shallow anterior chamber angle, iris-corneal contact, negative pupillary reflex, total pupillary block, negative fundus reflex, schiotz IOP 81 mmHg. Discussion : The patient diagnosed as right eye acute glaucoma and treated with acetazolamide, timolol maleate eye drops, potassium aspar tablets, prednisolone acetate drops, diclofenac sodium drops in the right eye, paracetamol tablets, re-evaluate in 2 hours. The patient chose to be referred to a hospital in Surabaya. The patient came back with the same complaint and was treated the same as before, right eye surgery trabeculectomy + peripheral iridectomy with releaseable suture flap limbal base with controlled IOP results, releaseable suture sutures were removed in 2 weeks. Trabeculectomy of the uveitic eye is generally less successful because of accelerated wound healing by the postoperative fibrinous and cellular response. Antimetabolites such as 5FU and Mitomycin C are used to enhance the success of trabeculectomy in uveitis eyes (5FU, MMC). 95% success (IOP less than 21 mm Hg with 1 or no treatment) was achieved with MMC augmented trabeculectomy. Conclusion : Increased IOP due to pupillary block causes acute glaucoma with signs of high IOP, middilated pupils, decreased pupillary reflexes, and irregular shape, corneal epithelial edema, episcleral and conjunctival vascular congestion, shallow anterior chamber, small number of flares and cells.

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