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Macular hole surgery under retrobulbar local anesthesia increases visual acuity Simanjuntak, Gilbert WS; Simanjuntak, Golda AM; Christine, Reinne Natali
Universa Medicina Vol 36, No 3 (2017)
Publisher : Faculty of Medicine, Trisakti University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18051/UnivMed.2017.v36.160-165

Abstract

Background Macular hole surgery can be done under general or local anesthesia, and general anesthesia is still the standard procedure. The objective of this study was to investigate the results of macular hole surgery under local anesthesia. MethodsA retrospective study on medical records of patients who had undergone macular hole surgery under local anesthesia. Funduscopic examination of macular hole had been performed and all other diseases with deterioration of visual acuity eliminated. Surgery was performed under retrobulbar local anesthesia, using 2 ml of 2% lidocaine mixed with 3 ml bupivacaine in one syringe. Vitreous tamponade used 20% sulfur hexafluoride (SF6). Demographic and clinical characteristics, visual acuity before and after surgery, and improvements that occurred were assessed. Results No significant interruption occurred during surgery. Mean age of the patients was 53.89 ± 13.3 years (22-74 years), with mean duration of symptoms of 48.83 ± 100.51 weeks (1-560 weeks). The patients comprised 20 males (55.6%) and 16 females (44.4 5). There were improvements in visual acuity after surgery in 31 patients (86.1%), the rest (13.9%) had identical or lower visual acuity after surgery. A total of 20 patients (55.6%) had postoperative visual acuity of 6/18 or better. Initial mean preoperative visual acuity was 0.08 ± 0.08 (0.01 - 0.29) and improved after the surgery to 0.38 ± 0.26 (0.00 - 1.00), the improvement being statistically significant (p=0.000). ConclusionRetrobulbar anesthesia is an effective and safe method in macular hole surgery. Macular hole surgery can be done well under local anesthesia, and visual acuity improved significantly.
Males tend to come earlier for eye care with the National Health Coverage Programme in private hospitals Simanjuntak, Gilbert WS; Tan, Jannes F; Christine, Reinne Natali
Universa Medicina Vol 37, No 2 (2018)
Publisher : Faculty of Medicine, Trisakti University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18051/UnivMed.2018.v37.127-134

Abstract

BackgroundCataract is the leading cause of blindness in Indonesia, and poverty is a major barrier to having cataract surgery. Increasing the proportion of adults that have regular, comprehensive eye examinations for cataract and other common eye health problems is one of the National Health Insurance (JKN) objectives. The objective of this study was to determine the impact of vision insurance on eye care utilization of cataract patients in private hospitals with the JKN system as social intervention. MethodsA cross-sectional study was conducted involving 230 cataract patients in a private hospital. Inclusion criteria were patients with cataract surgery, diagnosis and follow up visit minimally two months after surgery. A multiple logistic regression was used to analyse the data.ResultsInitial visual acuity (VA) was 0.13 ± 0.15 and final VA was 0.91 ± 0.15. Two patients had final VA of 0.2 and 0.15, respectively, in which the first was associated with persistent corneal edema and diabetes mellitus, and the other with corneal scar. Age, gender, and level of education were not associated with VA at the first visit (p>0.05). Further analysis using a multiple logistic regression model was found to be significant (p=0.0104), with gender being associated with preoperative vision, where males tend to come earlier to undergo cataract surgery/treatment.ConclusionMales tend to come earlier than females for cataract surgery with the National Health Insurance (JKN) programme, despite the social intervention of the programme.
Acute Primary Angle Closure: Case Report Christine, Reinne Natali
Indonesian Journal of Global Health Research Vol 7 No 4 (2025): Indonesian Journal of Global Health Research
Publisher : GLOBAL HEALTH SCIENCE GROUP

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37287/ijghr.v7i4.6332

Abstract

Acute primary angle-closure is an ocular emergency caused by the rapid increase in intraocular pressure due to outflow obstruction of aqueous humor. The major predisposing factor is the structural anatomy of the anterior chamber, leading to a shallower angle between the iris and the cornea. The medical treatment for acute angle-closure glaucoma aims to decrease the intraocular pressure by blocking the production of aqueous humor, increasing the outflow of aqueous humor, and reducing the volume of the aqueous humor. Iridotomy laser should be chosen to open the angle blockage, while trabeculectomy is occasionally performed on eyes that do not respond to medical therapy. Aims to comprehensively describe the management and clinical course of a patient with primary acute angle closure (PAAC). This report also aims to improve clinicians' understanding of the importance of early diagnosis, appropriate treatment, and long-term follow-up in preventing complications that can lead to permanent vision loss. This study is a descriptive study with a case report design. Data were obtained retrospectively from the medical records of patients diagnosed with acute primary angle closure at Christian University Hospital, Jakarta. Information collected includes patient identity, anamnesis, physical and supporting examinations, diagnosis, therapeutic interventions, and clinical outcomes during treatment and follow-up. The data were then analyzed qualitatively and presented narratively according to the clinical case report format. A 51-year-old woman who developed an acutely painful eye with loss of visual acuity a day before admission. She reported a sensation of pressure and blurry vision in her right eye with no apparent exacerbating factors. The first examination was performed on Uncorrected Visual Acuity (UCVA), where the UCVA was measured as 1/60 OD and 0.4 OS. Slit-lamp examination of the right eye showed moderate conjunctival injection, corneal edema, and pigment deposits on the corneal endothelium. The anterior chamber of both eyes was shallow; gonioscopy findings in the right eye were Schwalbe lines in four quadrants and three in the left. The crystalline lens was clear, and the IOP was measured as 67 mmHg OD and 16 mmHg OS. Acute Primary Angle Closure is an emergency condition that challenges the eye doctor to reduce IOP as soon as possible. The failure of maximum medication to reach the IOP below could lead to the condition to surgery. Even Trabeculectomy has several cautions to consider in this case, but it succeeds in lowering IOP and increasing the patient's visual acuity. Close monitoring is required to avoid the risk of postoperative complications.
Trabeculectomy Surgery in Primary and Secondary Glaucoma: Retrospective Cross-sectional Analysis Christine, Reinne Natali; Tanong, Nicolas Dwiki; Rombe, Claudia Valoryn Iona; Angreni, Frisca
Journal of Applied Nursing and Health Vol. 7 No. 2 (2025): Journal of Applied Nursing and Health
Publisher : Chakra Brahmanda Lentera Institute

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55018/janh.v7i2.333

Abstract

Background: Glaucoma remains a leading cause of permanent blindness worldwide, with elevated intraocular pressure (IOP) as the most modifiable risk factor. When medical therapy fails, trabeculectomy is often the preferred surgical option, though its effectiveness may differ based on the type of glaucoma. Primary glaucoma is typically idiopathic, while secondary glaucoma results from identifiable causes such as trauma, inflammation, or diabetes. Understanding these distinctions is essential for optimizing surgical outcomes and tailoring patient-specific treatment strategies. This study aims to determine whether there is a difference between the reduction in intraocular pressure in primary and secondary glaucoma after undergoing trabeculectomy surgery. Methods: This descriptive cross-sectional study used purposive sampling to select medical records of patients who underwent trabeculectomy at the Christian University of Indonesia Teaching Hospital from July 2021 to June 2022. A total of 30 patients were included. Inclusion criteria were patients diagnosed with either primary or secondary glaucoma who underwent trabeculectomy and had complete pre- and postoperative IOP data. Exclusion criteria included patients with previous glaucoma surgery, incomplete medical records, or less than one month of follow-up. The primary outcome was the percentage reduction in IOP one month postoperatively.. Results: The results showed that the percentage reduction in IOP within 1 month in primary glaucoma was 43.54%, whereas in secondary glaucoma, it was 41.87%. P value > 0.05 in all postoperative IOPs between primary glaucoma and secondary glaucoma. Conclusion: Trabeculectomy is still the first choice to reduce IOP, which has failed pharmacological treatments. However, there was no significant difference between decreased intraocular pressure in patients with primary and secondary glaucoma.