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All Journal Universa Medicina Indonesian Journal of Global Health research Journal of Applied Nursing and Health
Reinne Natali Christine, Reinne Natali
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Journal : Universa Medicina

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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.
Co-Authors Angreni, Frisca Gilbert WS Simanjuntak, Gilbert WS Golda AM Simanjuntak, Golda AM Rombe, Claudia Valoryn Iona Tan, Jannes F Tanong, Nicolas Dwiki