Nuradianti, Lydia
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Journal : Ophthalmologica Indonesiana

Bleb Needling Procedure in Juvenile Open Angle Glaucoma (JOAG) for Failed Bleb in Trabeculectomy: Poster Presentation - Case Report - General practitioner Putri, Rizqi Suryani; Nuradianti, Lydia
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/m1y43690

Abstract

Introduction : JOAG is less responsive to medications and often requires surgical therapy. The main choice of surgery is trabeculectomy. One of its success rates is determined by the formation of bleb. Failed bleb causes an increase in IOP. To repair the bleb, bleb needling can be performed as a simple procedure. Case Illustration : A 7-year-old boy came with a chief complaint of pain accompanied by redness of the left eye. The patient was diagnosed with JOAG and had underwent trabeculectomy with mitomycin-C (MMC) 3 months ago on the right eye and 2 months ago on the left eye with complete success surgery. On physical examination, intraocular pressure (IOP) was 12 mmHg / 29 mmHg with flat bleb on the left eye. Visual acuity on the right eye was 3/10 with cc C-2.00 X 0° ? 7/10 while on the left eye was light perception without possible refractive correction. Timolol maleate and latanoprost eye drops were given for 2 weeks but the IOP remained high. Therefore, the patient underwent bleb needling with 5- Fluorouracil (5-FU) on the left eye. Post-operatively, the IOP was 12 mmHg without antiglaucoma medication. Discussion : Failure of the trabeculectomy bleb can occur due to fibrotic proliferation as part of the wound healing response. Studies stated 5-FU bleb needling provide clinically significant IOP lowering and minimal complication. Reduced IOP post needling and formation of bleb indicate successful needling. Conclusion : Bleb is an important indicator of a success trabeculectomy surgery. Bleb needling with 5-FU could be considered as effective and safe procedure after trabeculectomy failure.
The Challenges of Handling Neovascular Glaucoma at Undaan Eye Hospital Surabaya, Indonesia: Poster Presentation - Observational Study - General practitioner Malika, Rosalia Adriani; Nuradianti, Lydia
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/cmqb7053

Abstract

Introduction & Objectives : The management of neovascular glaucoma is challenging because frequently it is incurable with poor visual prognosis. Delay in treatment can lead to sight threatening glaucoma. This study aimed to provide an overview of incidence and management of neovascular glaucoma at Undaan Eye Hospital. Methods : This descriptive epidemiology study comprised 111 eyes of 102 patients. The inclusion criteria were patients diagnosed with NVG who came to Undaan Eye Hospital for 1 year (January 2021 to December 2021). Patients with incomplete medical records were excluded. The patient’s age, gender, risk factors, and treatment were reviewed. Results : There were 102 patients (111 eyes) diagnosed with NVG. The patients were mostly men (53,2%) and the mean age was 54.98 ± 12,4 years. Diabetes Mellitus (DM) was observed in 70 (63,1%) eyes, hypertension in 60 (54,1%) eyes, central retinal vein occlusion (CRVO) in 11 (9,9%) eyes, cholesterol in 7 (6,3%) eyes, and branch retinal vein occlusion (BRVO) in 1 (0,9%) eyes. Mean IOP at the time of diagnosis was 42,8 ± 11,2 mmHg. Anti-VEGF (25,2%), trabeculectomy (59,5%), glaucoma drainage device (17,1%), micropulse transscleral cyclophotocoagulation (5,4%) were done as an option of the treatment. Conclusion : NVG is more common in men. Most patients presenting NVG had DM and hypertension with mean IOP of 42,8 mmHg. Trabeculectomy is the most commonly performed procedure.