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All Journal International Journal of Information Techonology and Education (IJITE) Ophthalmologica Indonesiana
Kasih, Franky
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Computer Science & IT Health Professions Medicine & Pharmacology Public Health Other

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Analysis of Policy and Politics in Education on Phacoemulsification Training for Newly Graduated Ophthalmologists Lumapow, Harold R; Sumanti, Eugeni; Surbakti, Salam; Hartonoi, Yuliana; Kasih, Franky; Umboh, Anne
International Journal of Information Technology and Education Vol. 4 No. 3 (2025): June 2025
Publisher : JR Education

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Abstract

The increasing burden of cataract-induced blindness in Indonesia demands competent surgical responses, particularly through the phacoemulsification technique—a minimally invasive surgical procedure globally recognized as the gold standard. However, structural limitations in training policies, unequal access to resources, and political dynamics impede the readiness of new ophthalmologists in mastering this technique. This study explores the systemic, policy, and political contexts underlying phacoemulsification training in Indonesia. Using a qualitative descriptive approach supplemented by a literature review, this research analyzes dimensions of curriculum development, accreditation standards, infrastructure distribution, stakeholder politics, and professional ethics compliance. Findings indicate that to ensure equitable surgical competence among graduates of ophthalmology specialist programs, policymakers need to integrate national regulations with international standards, decentralize access to quality training, and enforce ethical governance across all medical education institutions.
A Case of Malignant Glaucoma Following a Trabekulectomy: Poster Presentation - Case Report - Resident Rumampuk, Irene M. A.; Kasih, Franky
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: 10.35749/7djvcj51

Abstract

Introduction : Malignant Glaucoma (MG) is characterized by a shallow anterior chamber (AC) associated with a raised intraocular pressure (IOP) usually following a filtration surgery in eyes with angle closure. Case Illustration : A 56-year-old female patient presented on the second day post trabeculectomy with a shallow AC. The patient experienced ocular pain on the 2nd day post-op. Visual acuity was 6/40 and NCT was 57 mmHg in her LE. Slit lamp examination showed an absent peripheral AC the patient was treated with oral acetazolamide, topical timolol, topical brimonidine, and topical cycloplegics. 24 hours later, the IOP was 34 mmHg, absent AC with mild corneal edema. The diagnosis was Glaucoma Maligna post Trabeculectomy ec Acute attack PACG. After a month, corneal edema has resolved, visual acuity was 6/12, IOP was 27.6mmHg. Discussion : The exact mechanism of MG remains unclear. There is likely to be an anatomical interaction between the ciliary processes, lens, and anterior vitreous face which causes the diversion of aqueous backwards into the vitreous cavity and causing the anterior rotation of the cilliary processes therefore blocking the aqueous outflow. Although, in our case this problem was moderated by cycloplegics and glaucoma medications, literature describes interventions such as lens extraction, posterior capsulotomy, anterior vitrectomy and pars plana vitrectomy was necessitated in some cases to decrease IOP. Conclusion : MG is a sight threatening condition caused by a raised IOP in the presence of a patent iridectomy usually occurring after an intraocular surgery. The management of this condition could vary from medications to surgical interventions.
Steroid Induced Glaucoma and Primary Angle Closure Glaucoma: A Case Report of Mixed Mechanism Glaucoma: Poster Presentation - Case Report - Resident Masloman, Anugrah Handini; Kasih, Franky
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/kgps5q05

Abstract

Introduction : Steroid induced glaucoma is a form of secondary open angle glaucoma (OAG) caused by adverse effects of steroid usage. Primary angle closure glaucoma (PACG) is characterized by shallow anterior chamber accompanied by peripheral anterior synechiae (PAS), elevated IOP and glaucomatous optic neuropathy (GON). Case Illustration : A 58 year-old woman presented with red eye, blurry vision, pain in her right eye radiating to the head, watery eye and halo. History of experiencing recurrent red eye, improving after taking steroid topical drug for about 3 months. Visual acuity 6/20 ph 6/20, IOP 39 mmHg, mixed conjunctival injection, shallow anterior chamber Van Herick 1-2, dilated pupil and iris pigment on anterior capsule of lens. Posterior segment showed glaucomatous optic neuropathy with cup disc ratio 0.8-0.9, anterior chamber depth 2.58, and thinning of optic nerve head layer. Patient was diagnosed with steroid induced glaucoma and mixed mechanism PACG. The patient underwent trabeculectomy procedure after mannitol injection was given to reduce IOP. Discussion : We diagnosed the patient with steroid induced glaucoma and mixed mechanism PACG based on history, clinical findings, and diagnostics. Steroid raised IOP by accumulating polymerized glycosaminoglycans (GAGs) in the trabecular meshwork, producing "biologic edema" thus increased outflow resistance. PACG was determined based on Van Herick and anterior chamber depth. Trabeculectomy remains an effective treatment in this case where medications were failed to control IOP. Conclusion : Steroid induced glaucoma commonly found in OAG, definitive treatment includes halting steroid drugs and trabeculectomy. Further follow-up is needed to evaluate angle closure mechanism.
Co-Authors Hartonoi, Yuliana Irene M. A. Rumampuk, Irene M. A. Lihart Lumapow Masloman, Anugrah Handini salam surbakti, salam Sumanti, Eugeni Umboh, Anne