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Ophthalmologica Indonesiana
Published by Perhimpunan Dokter Spesialis Mata Indonesia
ISSN : 01261193     EISSN : 2460545X     DOI : 10.35749
Core Subject : Health,
Health Professions Medicine & Pharmacology Public Health
Ophthalmologica Indonesiana is an open accessed online journal and comprehensive peer-reviewed ophthalmologist journal published by the Indonesian Ophthalmologist Association / Perhimpunan Dokter Spesialis Mata (PERDAMI). Our main mission is to encourage the important science in the clinical area of the ophthalmology field. We welcome authors for original articles (research), review articles, interesting case reports, special articles, clinical practices, and medical illustrations that focus on the clinical area of ophthalmology medicine.
Arjuna Subject : Kedokteran - Ophthalmology
Articles 869 Documents
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A Challenging Case of Simple Limbal Epithelial Transplantation (SLET) in Limbal Stem Cell Deficiency Following Chemical Injury: A Case Report: Poster Presentation - Case Report - Resident Amanda, Lia; Widyawati, Syska; Martha, Faraby; Zarwan, Jessica
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/ahx7p888

Abstract

Introduction : Limbal stem cell deficiency (LSCD) often arises following trauma or inflammation that hinders corneal epithelium healing, commonly caused by chemical or thermal injuries. Despite significant advancements, treating LSCD remains challenging. This case highlights a challenging case of simple limbal epithelial transplantation (SLET) in LSCD following chemical injury. Case Illustration : A 20-year-old male presented with reduced vision in left eye following an alkaline chemical injury (grade III) was diagnosed with unilateral LSCD. Upon examination, conjunctivalization of the peripheral cornea, a central corneal cicatrix, and stromal neovascularization present after previous necrotomy, tenoplasty, and amniotic membrane transplantation (AMT). The patient then underwent SLET, with limbal biopsies from the collateral eye. Four months after surgery the visual acuity improved from 3/60 to 6/15 with spectacles. However, the cornea conjunctivalization still developed despite improved visual acuity. Discussion : To effectively manage the recurrence of stem cell deficiency, other stem cell transplantation techniques are needed to manage the problem. Combining different limbal stem cell transplantation approaches can be customised to address the problem and achieve lasting results. Conclusion : Prompt diagnosis and treatment of LSCD is crucial to prevent complications and blindness. SLET is a surgical option for LSCD after chemical injury, but this report highlights a challenging case and the need for the alternatives approaches.
SCREENING ON CATARACT APPLICATION (SERIOC): Poster Presentation - Observational Study - Ophthalmologist Wulansari, Sriana; Sungkono, Henry Santosa; Akbar, Muhamad Hassanul
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: 10.35749/6mwpy856

Abstract

Introduction & Objectives : West Nusa Tenggara is a province that has the second highest prevalence of blindness at the national level according to the results of the 2014 Rapid Assessment of Avoidable Blindness (RAAB) survey. During the covid-19 period the offline cataract screening is not permitted, as a result it’s difficult to reach underprivileged and isolated areas, also people with disabilities. In 2021 West Nusa Tenggara Eye Hospital launched a smartphone-based eye health examination application Screening On Cataract namely SERIOC, while still paying attention to service standards clinically and in management. SERIOC can be used by public health as the nearest public health facility. Methods : The waterfall method is used in the development of this application, The waterfall methodology is a project management approach that emphasizes a linear progression from beginning to end of a project. This methodology, is front-loaded to rely on careful planning, detailed documentation, and consecutive execution. Results : SERIOC has successfully screened 2,713 patients from 2021 with 2117 patients diagnosed cataract and 593 patients diagnosed non-cataract whose data is centralized and directly connected to an ophthalmologist at the West Nusa Tenggara Eye Hospital. Patients diagnosed with cataracts will be referred to the hospital for further action. Conclusion : Based on the information above, it can be concluded that SERIOC application in eye health screening is very effective and efficient method to avoid blindness on West Nusa Tenggara.
Secondary Piggyback Intraocular Lens for Correcting Refractive Surprise Post Silicone Oil Removal: Poster Presentation - Case Report - Resident Juanarta, Pieter; Knoch, Andrew M.H.; Budiman; Sugiarti, Emmy Dwi; Tjokrovontjo, Ludwig Melino
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: 10.35749/03djjh28

Abstract

Introduction : Pseudophakic refractive error can be caused by IOL malposition and inaccurate biometric examination. Treatment consists of IOL exchange, refractive laser correction, and secondary piggyback IOL. Secondary Piggyback IOL consist of customized IOL implantation on ciliary sulcus. Case Illustration : A Male, 62 years old, complains of blurry right eye. He underwent retinal surgery with silicone oil tamponade surgery 5 years ago and underwent silicone oil evacuation, phacoemulsification, and intraocular lens implantation one year later. The visual acuity of the right eye was 1/60 with BCVA of 0.2. He was diagnosed with Pseudophakia of both eyes and Hypermetropia Surprise of the right eye. He was planned to undergo piggyback intraocular lens implantation in the right eye (Figure 1). The visual acuity one week after operation of the patient's right eye was 0.32 (Figure 2). Discussion : Biometric examination in eye with silicon oil tamponade have longer axial length, causing pseudophakic refractive errors. Treatments consist of IOL replacement, refractive laser correction, and piggyback IOL implantation. IOL replacement has a high risk and requires quite high operator skills. Refractive laser correction is performed in small refractive errors. Piggyback IOL implantationis easier, safer, have more accurate IOL power, and reversible. Conclusion : Power of the intraocular lens is influenced by axial length, keratometry reading, lens thickness, and other parameters. Axial length measurement in patients with silicone oil tamponade requires greater accuracy to prevent pseudophakic refractive errors. IOL Piggyback implantation procedure is an alternative in person that can’t undergo laser correction or IOL exchange.
A snake venom ophthalmia: A case – report: Poster Presentation - Case Report - Resident Aljufri, Nabila; Sadikin, Irma Suwandi; Petra, Dany; Susantono, Diannisa; Oktariani, Virna Dwi; Widyawati, Syska
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/vm6dv861

Abstract

Introduction : Snake venom ophthalmia is caused by venoms of spitting snakes. Delayed treatment may result in corneal ulcer, corneal perforation and blindness. We aim to report a fortunate snake venom ophthalmia case. Case Illustration : A-54-year-old male complained of burning eye pain, watery, and redness of the right eye (RE) after being spat by a snake 3 hours before admission. The snake was identified as a cobra-snake, spitted at a distance of 1 meter without body bite. He rinsed his eyes with tap water and irrigated at a nearby hospital before referred. During the admission, the pH of both eyes (BE) was 8. The patient was irrigated with normal-saline. The visual acuity (VA) of the right eye was 6/12 and left eye 6/6. There was RE conjunctival and ciliary injection. Other examinations were unremarkable. The patient was discharged and treated with levofloxacin eye-drop, sulfas-atropine 1%, EDTA 1%, artificial tears, and vitamin C. He did self-eye irrigation. Two days later, he presented with VA of 6/6 for BE with normal ocular examinations and pH of 7 for BE. Discussion : The general principle is prompt and copious irrigation of the eyes in chemical contact. The snake venom mixture of chemicals was washed out, which local necrosis can be prevented. Managing snake venom as a chemical splash injury with considerable irrigation, lubricants, and topical antibiotics, resulted a good outcome and prevented sequelae in this patient. Conclusion : Urgent irrigation of the affected eyes and other mucous membranes is the key in treating snake venom ophthalmia
Successful Management of Cataract in Patient With Long Anterior Zonules and Small Pupil :A Rare Case: Poster Presentation - Case Report - Ophthalmologist Pangestika, Riskha; Rhendy, Rio; Widyawati, Syska
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/e9shxj46

Abstract

Introduction : Long anterior zonules (LAZ) are rare disease with prevalence was 1–2%, characterized by zonular fibers that extend centrally leading to a small zonule-free zone (ZFZ), which raises the risk of complications during zonular cutting while continuous curvilinear capsulorhexis (CCC). This leads to two options whether to perform phacoemulsification through a small CCC within the small ZFZ or an adequately sized CCC. The objective of this study was to report challenging management of phacoemulsification surgery with LAZ eyes with small pupil Case Illustration : A 62 y.o female had visual acuity(VA) 0.7(logMAR) due to corticonuclear cataract in left eye. She had history complicated cataract surgery with secondary sulcus fixated IOL in her fellow eye. The IOP was normal, no phacodenesis and pseudoexfoliative material observed in left eye. The posterior segment was normal. The left eye observed otherwise normal in initial examination. Intraoperatively, after viscomidriasis technique the ZFZ identified in the area of 2.0-2.5 mm from central. Five millimeter CCC can be achieved in the central area and phacoemulsification with the help of CTR (Capsular Tension Ring) safely performed and one piece IOL was implanted in the bag. Discussion : On the first postoperative day, VA was improves to 0.4(logMAR), IOL central and clear corneal with minimal inflammation. One week after surgery, the VA 0.3(logMAR) and no sign of IOL decenteration. Conclusion : Phacoemulsification in eyes with LAZs can be safely performed with CTR through an adequately sized CCC without significant complications. A combination of early recognising high-risk eye, proficient skills, and surgical instruments can improve outcome.
Tenon Patch Graft in The Management of Corneal Perforations: A case series: Poster Presentation - Case Series - General practitioner Diba, Amirah Deandra; Martha, Faraby
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: 10.35749/7rvvas25

Abstract

Introduction : A full-thickness defect of the cornea that results in a rupture or opening is known as corneal perforation. Despite corneal transplant being the gold standard therapy, finding a donor remains challenging. Tenon patch graft (TPG) may be the alternative surgical procedure to repair the damaged cornea. This case series presents six cases of corneal perforations that have been effectively managed with TPG. Case Illustration : Six cases with corneal perforations in the age range of 6-75 years old were presented with varying perforation sizes ranging from 0.5 to 8 mm. The most common complaints were vision loss, redness, and watery eyes. Ophthalmology examinations revealed five corneal ruptures and one impending corneal rupture caused by trauma, infections, corpus alienum, and post-operative. All patients underwent TPG surgery with compression/infinity sutures using 10-0 nylon, followed by bandage contact lenses, with three adjoined with amniotic membrane transplant. Post TPG, patients were followed up for 1-4 months and no complications such as glaucoma, cataract, or endophthalmitis were found. Discussion : Corneal damage that is not treated promptly causes further erosion of the deeper corneal layers. When medication fails, other measures must be taken to preclude further damage. TPG may be an accessible and cost-effective surgical procedure of choice to preserve eye integrity both functionally and structurally. Conclusion : This case series of tenon patch grafts for corneal perforations less than 9 mm demonstrated the effectiveness of TPG in promoting corneal healing without significant complications. Despite differences in perforation size and patient characteristics, all six cases saw closure of the perforation.
FAMILY’S VIEW REGARDING THE DECISION TO BE A CORNEA DONOR: A PHENOMENOLOGICAL STUDY Baswedan, Rizki Hafidzah; Padmawati, Retna Siwi; Widyandana, Doni
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/a1f2ma34

Abstract

Introduction and Objective: Family has an important role in the corneal donor process. Corneal extraction can be done when a potential donor dies, so it requires family involvement and support. The purpose of this study is to explore the family's view on the decision to be a cornea donor so that we can obtain a deep understanding on this issue. Methods: Phenomenological studies were conducted in Yogyakarta, Indonesia on families of prospective cornea donors (n=6) and registered cornea donor candidates (n=6). Data were collected using in-depth interviews and study documents. Data were analyzed using the Colaizzi’s method. Results: Family participants' knowledge and understanding of the urgency and procedure of corneal donors is the main point that constructs their view of corneal donors. Most family participants consider being corneal donors a good thing to do. All participants expressed their willingness to carry out the will of prospective donors, but there was no guarantee they would do so. Fifty percent of participants’ families are also interested in becoming corneal donors in consideration of religious organizations, educational background, and experience participating in activities with the Eye Bank and the donors. Conclusion: Families have an important role in the corneal donor process because they will carry out the will of prospective donors and serve as liaisons for the Eye Bank. Family involvement in the promotion of the cornea donor program is needed.
Ab Externo Scleral-Fixated Intraocular Lens As A Management in Aphakic Eye: Poster Presentation - Case Report - Resident Sudjana, Briska; Knoch, Andrew M.H.; Budiman; Sugiarti, Emmy Dwi; Melino, Ludwig
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: 10.35749/435khp24

Abstract

Introduction : Varied technique of secondary intraocular lens (IOL) implantation are exist. Scleral-fixated IOL implantation become popular both with or without sutures. The one of sutures technique is ab externo Case Illustration : A 68 year old man came with blurry vision on left eye (LE) since one month ago. He had history of primary angle closure suspect and posterior subcapsular cataract on LE and managed with Intracapsular Cataract Extraction in January 2021. Ophthalmology examination of LE revealed uncorrected visual acuity (UCVA) 1/60, irregular updrawn pupil with diameter 7.4mm x 5.3 mm, and aphakic lens. The best corrected visual acuity (BCVA) with S+12.00 C-0.75 x 80 was 0.4f. The patient underwent secondary IOL by using 3 pieces IOL with ab externo scleral- fixated on his left eye (Figure 1). Power IOL determined was +24.00 diopter with target of refraction was emmetropia. One day postoperatively, the UCVA was 0.08 pinhole 0.125 with good centration of scleral fixation IOL. First month postoperatively, BCVA with S-1.75 C-1.00 x 50 was 0.4 on snellen chart. Discussion : Aphakia with inadequate capsular support can be seen in several conditions. Technique of introducing two suture loops for scleral fixation of an IOL by ab externo procedure, which proved safe and effective. Scleral fixation of IOL in the posterior chamber, although technically demanding, allows good visual outcomes. Conclusion : Ab externo scleral-fixated IOL implantation is an effective rescue procedure for eyes with deficient capsular support.
HUMAN RESOURCES DEVELOPMENT IN CHILDREN EYE HEALTH SERVICES IN SOUTH SULAWESI Amalius, Ahmad Ashraf; Muhiddin, Habibah Setyawati; Ichsan, Andi Muhammad; Faisal, Andi Akhmad; Kamaruddin, Muhammad Irfan; Akib, Marlyanti N.; Kotha , Satya Prabha
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/rc04ab34

Abstract

Introduction: Children eye health are one of the most common problems in ophthalmology that are getting attention globally and nationally especially in South Sulawesi. To optimize its services quality and quantity of human resources are required. This study aims to report the human resources development in children eye health services in South Sulawesi. Methods: Surveys were carried out in several districts to assess the availability of human resources in children eye health services. Creating collaborations with several institutes such as Faculty of Medicine, Hasanuddin University and related professional organizations. Conducting several trainings in provinces, districts, subdistricts, village, and urban village. Results: Preparation and dissemination of materials and media on prevention of blindness in children, improvement of human resources in the form of District Trainer training in 24 districts that recruited 98 people who were ready to become trainers. For 2 years conducting tiered training at 24 districts, they produced human resources of 1,395 officers at the Puskesmas, 11,145 posyandu cadres, and 3,826 teachers. The results of this built system revealed that 3,248 paediatric patients were screened with vision problems, 3,528 toddlers in Integrated Health Centre were screened and referred to Health Centre as many as 426 toddlers, and at the School Health Unit it was recorded that 173,778 children were screened and there were 28,845 (17%) children who had visual disturbances. Conclusion: Development of human resources in children eye health in Indonesia was not only the responsibility of the government and the health sector but also need cross-sectoral roles.
INTRAOCULAR LENS EXCHANGE PROCEDURE AS A MANAGEMENT FOR INTRAOCULAR LENS DISCOLORATION: Poster Presentation - Case Report - Resident Arrizasyifaa, Raden Muhammad Tanri; Sugiarti, Emmy Dwi; Tjokrovonco, Ludwig M.; Knoch, Andrew MH.; Budiman
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/a8c7tp70

Abstract

Introduction : Intraocular lens (IOL) discoloration is a rare complication of cataract surgery. It may result in severe visual function impairment and potentially lower the patient's quality of life. IOL exchange is an unusual procedure as the incidence rate was 2 per 1000 surgeries over 8 years. It is the surgical procedure of choice for symptomatic IOL discoloration. Case Illustration : A 50-year-old man came to the hospital complaining of a right eye blurry vision for the previous two months. His right eye had undergone cataract surgery seven years earlier. After having cataract surgery, the patient's vision was clear, but five years later, it began to feel blurry and glare. The patient has a history of well-controlled type II diabetes and hypertension. An intraocular lens discoloration was discovered after a careful examination of the eye (figure 1). For his right eye, the patient underwent an IOL exchange procedure (figure 2). A square-edge single-piece foldable IOL was obtained from the surgery. Follow-up examinations after surgery revealed an improved visual function and a clear intraocular lens (figure 3). Discussion : IOL discoloration may occur years after surgery. It is related to the type of IOL, local ocular factors, and the patient's systemic condition. The IOL exchange procedure consists of IOL extraction and secondary IOL implantation. The extraction can be done by cutting, splitting (bisecting), or folding the IOL. Different methods of fixation can be used for secondary IOL implantation. Conclusion : The IOL exchange procedure can optimally restore visual functions after a severe decline caused by IOL discoloration.

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