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All Journal Vision Science and Eye Health Journal Ophthalmologica Indonesiana
Dharmawidiarini, Dini
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Health Professions Medicine & Pharmacology Public Health

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Flap Striae: Managing and Understanding Post-LASIK Complication Khoirunnisa, Auliya; Nuramalia, Lady Sherly; Rasyda, Risnanda Putri; Dharmawidiarini, Dini
Vision Science and Eye Health Journal Vol. 3 No. 2 (2024): Vision Science and Eye Health Journal
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/vsehj.v3i2.2024.33-35

Abstract

Introduction: Flap striae is the most common postoperative complication, with a frequency ranging from 0.033% to 3.5%, according to studies involving over 1000 ocular cases. There is only one case in our hospital in 2023. In this case report, we will present a case of flap striae in a tertiary hospital because our findings are unusual and essential in symptomatic therapy and visual rehabilitation. Case Presentation: A 19-year-old female came with a chief complaint of impaired vision in her left eye for the past two weeks, followed by inability to focus, discomfort of the eye, a sensation of foreign body, and glare that occurred three days after she underwent bilateral myopia laser in situ keratomileusis (LASIK) surgery. A post-LASIK assessment found that both eyes had visual acuity 10/10, and the left eye's visual acuity dropped to 6/10. Slit lamp examination revealed flap striae were running from the superonasal to the inferolateral quadrant. The thickness disparities were measured using optical coherence tomography (OCT), ranging from 653 to 689 μm. The OCT pictures revealed a gap on the temporal side as well. This patient was diagnosed with flap striae and a flap repositioning procedure was performed. Conclusions: A flap repositioning surgery was performed to increase visual acuity and eliminate striae.
Late Onset Corneal Haze Post Photorefractive Keratectomy Agnia, Emeralda Brilian; Kriskasari, Georgina Tara; Dharmawidiarini, Dini; Napitupulu, Sahata P. H.
Vision Science and Eye Health Journal Vol. 3 No. 3 (2024): Vision Science and Eye Health Journal
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/vsehj.v3i3.2024.65-68

Abstract

Introduction: Photorefractive keratectomy (PRK) is a surface ablation procedure to correct refractive errors. Regardless of the safety and efficacy, corneal haze may occur after PRK, and it remains one of the most feared complications because it can impair good visual outcomes. Case Presentation: A 20-year-old woman complained of blurred vision in her right eye (RE) after undergoing PRK elsewhere six months before admission with a history of refraction of S-12.75 C-1.75 x 10° preoperatively and S-0.75 postoperatively. Six-month postoperative uncorrected visual acuity (UCVA) was 0.01, best corrected visual acuity (BCVA) was 0.5 with S-7.00 C-0.75 x 50°. A slit lamp examination revealed grade three corneal haze. Anterior optical coherence tomography (OCT) showed the hyperreflective area with 132 μm deep into the stroma. The patient underwent phototherapeutic keratectomy (PTK) and mitomycin-C (MMC) treatment to a depth of 50 μm Ø6.5mm transition zone 0.5 mm. Two months later, UCVA was 0.2, BCVA was 0.63 with S-2.50 C-0.50 x 90°, and slit lamp examination revealed no haze remaining. Conclusions: This case illustrates the potential risk for corneal haze development, mainly when PRK is performed at greater treatment depths. However, with phototherapeutic keratectomy and mitomycin-C treatment, an excellent visual outcome and vision restoration can be obtained.
Intraocular Lens (IOL) Exchange Procedure in Refractive Surprise After Ten Years of Cataract Surgery Audina, Rizna; Zahrah, Alvi Laili; Dharmawidiarini, Dini; Napitupulu, Sahata P. H.
Vision Science and Eye Health Journal Vol. 3 No. 3 (2024): Vision Science and Eye Health Journal
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/vsehj.v3i3.2024.55-59

Abstract

Introduction: Postoperative refractive surprises may manifest following cataract surgery. A residual refraction difference of > 2.0 D after cataract surgery was considered a refractive surprise. Treating refractive error after cataract surgery includes non-surgical and surgical options. The objective is to report clinical outcomes of intraocular lens (IOL) exchange with ciliary sulcus placement technique to manage refractive surprise. Case Presentation: A female patient aged 70 years reported experiencing blurred vision in her right eye (RE) for the past two years. History of RE cataract surgery ten years ago, however, she only had control 1-2 times after surgery. After that, the patient underwent cataract surgery on the left eye (LE), and then she complained that her RE was getting blurry. Her RE's visual acuity (VA) was 1/60 with best corrected visual acuity (BCVA) S-8.00 C-1.00 X100° to 6/10, and her LE was 7/10 with BCVA C-0.75 X60° to 10/10. The anterior segment examination of the RE was a 3-piece sulcus intraocular lens with complete continuous curvilinear capsulorhexis (CCC) intact anterior capsule, posterior capsule rupture, and the LE was in the bag IOL. Ultrasound examination of the RE revealed posterior staphyloma. She was diagnosed with OD refractive surprise, pseudophakia, posterior staphyloma, and OS pseudophakia. She underwent IOL exchange surgery on her RE. Post-operatively, the visual acuity of the RE was 7/45 using the Snellen chart. Three months post-op, the BCVA of RE was 10/10. Conclusions: In well-prepared cataract surgery, unexpected refractive outcomes such as a refractive surprise can be prevented. IOL exchange with ciliary sulcus placement technique is a treatment option for refractive surprise associated with posterior capsule rupture, and it has a good outcome.
Retropupillary Iris-Claw Intraocular Lens Implantation in Aphakia Post-Endophthalmitis Zahra, Alvi Laili; Audina, Rizna; Dharmawidiarini, Dini; Napitupulu, Sahata P. H.
Vision Science and Eye Health Journal Vol. 4 No. 3 (2025): Vision Science and Eye Health Journal
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/vsehj.v4i3.2025.86-90

Abstract

Introduction: Endophthalmitis is a severe eye disease. Due to the previous condition, selecting the appropriate type of secondary intraocular lens (IOL) is challenging. The Objective of this report is to describe the outcome of retropupillary iris-claw intraocular lens (RP- ICIOL) implantation to treat aphakia in patients with low corneal endothelial cell count, lack of capsular support, and a history of endophthalmitis. Case Presentation: A 73-year-old female patient reported experiencing hazy vision in her right eye (RE) for four months following cataract surgery. The patient had previously been diagnosed with aphakia and endophthalmitis RE and was admitted for three days. The visual acuity of the RE was 1/60. On anterior segment examination, the cornea was clear, the anterior chamber was deep, there was no flare or cell, vitreous strands were present in the anterior chamber, and the pupil was irregular with an aphakic lens. Examination of the posterior segment was within normal limits. Specular microscopy showing corneal endothelial cell density (CECD) of RE was 1086 cells/mm2. The patient then underwent RP-ICIOL implantation. Post-operatively, the visual acuity of the RE improved to 6/25, and the intraocular pressure (IOP) was 11 mmHg, as measured using non-contact tonometry. Three months post-op, the visual acuity was 6/30, the IOP was 17 mmHg in the RE and the CECD was 1108 cells/mm2. Conclusions: Good and appropriate management of endophthalmitis can save a patient's vision. Secondary iris-claw IOL implantation is a viable treatment option for aphakia following endophthalmitis, offering the advantage of maintaining the physiologic posterior position and being minimally invasive.
New Generation of Small Incision Lenticule Extraction (SMILE) Procedure for Myopic Astigmatism with High Astigmatism Value : A Case Series: Poster Presentation - Case Series - General practitioner Putri, Rizqi Suryani; Dharmawidiarini, Dini; Moenir, Farida; Napitupulu, Sahata P . H.
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/zeb7s487

Abstract

Introduction : Myopic astigmatism is a refractive disorder which could cause visual impairment especially with high astigmatism value. It affects patients’ productivity and quality of life. The management for myopic astigmatism is challenging because no consensus on the ideal method was reached. Case Illustration : Case 1: 19-year-old male with Uncorrected Visual Acuity (UCVA) 3/60 in the right eye with a manifest refraction of S-3.25 C-2.00 x 0 and 2/60 in the left eye with a manifest refraction S-5.50 C-0.50 x 0. Case 2: 18-year-old male with UCVA 3/60 in both eyes with a manifest refraction of S-3.00 C-2.25 x 5 and S-2.50 C-2.00 x 0. Case 3: 18-year-old male with UCVA 3/60 in both eyes witha manifest refraction of S-2.75 C-2.00 x 0 and S-2.50 C-2.25 x 180. Slit lamp, fundus examination, corneal topography, tomography, epithelial thickness profile, and aberrometry were within normal limits. The patients underwent SMILE using Visumax 800 Femtosecond laser with 3-4 mm incision at 120°, optical zone between 6-6.8 mm and cap thickness between 100-120 ?m. Discussion : In this case series, SMILE was chosen because studies described SMILE as an effective and safe refractive procedure compared to Femtosecond Laser-assisted in situ keratomileusis (FS-LASIK). Target refraction is emmetropia without cyclotorsion adjustment, it showed that post operative UCVA in all eyes were 6/6 using Snellen chart and none of the eyes loss the BCVA. Conclusion : New Generation of SMILE as management of myopic astigmatism with high astigmatism value shows good result improving visual outcomes.
Co-Authors Agnia, Emeralda Brilian Audina, Rizna Khoirunnisa, Auliya Kriskasari, Georgina Tara Moenir, Farida Napitupulu, Sahata P . H. Napitupulu, Sahata P. H. Nuramalia, Lady Sherly Putri, Rizqi Suryani Rasyda, Risnanda Putri Zahra, Alvi Laili Zahrah, Alvi Laili