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All Journal Althea Medical Journal Berkala Kedokteran Ophthalmologica Indonesiana Ophthalmologica Indonesiana
Irawati Irfani
Department Of Ophthalmology, Faculty Of Medicine, Universitas Padjadjaran Cicendo National Eye Centre, Bandung, West Java
Biochemistry, Genetics & Molecular Biology Health Professions Immunology & microbiology Medicine & Pharmacology Physics Public Health

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Comparison of Corneal Endothelial Cells Loss After Phacoemulsification between Dispersive- Cohesive Viscoelastic (Soft Shell) and Adaptive Viscoelastic in Hard Density Senile Cataract Elvita Marer; Budiman Budiman; Irawati Irfani
Majalah Oftalmologi Indonesia Vol 42 No 1 (2016): Ophthalmologica Indonesiana
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/journal.v42i1.65

Abstract

Background: Phacoemulsification cataract surgery can cause endothelial damage. Endothelial damageduring phacoemulsification is caused by ultrasound energy (power), fluid turbulence, trauma by lensfragment, and the formation of air bubbles. To protect the corneal endothelium during phacoemulsification,we can use two types of dispersive and cohesive viscoelastic simultaneously (soft shell); dispersiveviscoelastic not entirely in aspiration, but still coats the endothelium during phacoemulsification. Theaim of this study is to compare the corneal endothelial cell loss one month after phacoemulsificationcataract surgery between dispersive-cohesive viscoelastic (soft shell) and adaptive viscoelastic in hardlens nucleus.Methods: This study was randomised clinical trials. Subjects were mature senile cataract patients,aged ≥50 years old, who came to Cataract and Refractive Surgery Unit at Cicendo Eye Hospital.Selection of the sample was consecutive admission, divided into two groups: dispersive-cohesiveviscoelastic (soft shell) and adaptive viscoelastic up to 13 samples per group. Examinations of cornealendothelial cells pre-surgical and one month post surgical were performed by a nurse in the diagnosticunit at Cicendo Eye Hospital, Bandung, by using specular microscope.Results: Corneal endothelial cell loss one month post surgery in the soft shell group was 1467.55 cells/mm2(59.09%) and adaptive viscoelastic group was 1682.3 cells/mm2 (60.32%). There was no statisticallysignificant difference between the two groups (p=0.184).Conclusion: Loss of post-operative corneal endothelial cells in cataract degree 5 and 6 was not statisticallysignificant between soft shell an adaptive viscoelastic group. Keywords: phacoemulsification, dispersive-cohesive (soft shell), corneal endothelial cells, specular microscope
Characteristics and Management of Anterior Segment Dysgenesis in Pediatric Ophthalmology Irawati Irfani; Sarah Nurul Ramadanti; Astrid Feinisia Khairani
Majalah Oftalmologi Indonesia Vol 42 No 3 (2016): Ophthalmologica Indonesiana
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/journal.v42i3.101

Abstract

Background: Anterior segment dysgenesis (ASD) is congenital anomaly caused by malformation of the eyeball during early pregnancy. Intrauterine ASD leads to disorder in maturation of anterior segment of the eye and its complications could interfere the normal visual development. There are several types of ASD and variability of its management. In this report, we described characteristic of ASD including its management in Cicendo Eye Hospital, Bandung. Methods: This is a retrospective descriptive study from medical records of patients with ASD in Cicendo Eye Hospital, Bandung since January 2012 until December 2014. Data were collected based on total sampling with inclusion criteria. All data were analyzed by statistical software. Results: There were 99 patients with range of age 1-day-old until 18-years-old who met the inclusion criteria of this study. Patient of ASD was commonly brought to the hospital at infant age (55.5%), boys in 51.5% patients and mostly came from out of town (70.7%). Thirty-seven percent of their mothers had history of drug consumptions during pregnancy and 30% born prematurity. Seventy percent cases of ASD were bilateral, 80.8% without systemic disease, and congenital glaucoma was the most common type of ASD (30.7%). The most common management was observation in 45.5% cases, followed by combination of surgical and medicamentosa in 30.3% cases. Conclusion: ASD is a congenital condition which has variability in types and management. Early recognition of this condition is necessary to decide the appropriate treatment to assist visual development and rehabilitation.  Keywords: anterior segment dysgenesis, characteristics, management   
Management of Pediatric Traumatic Cataract With An Open Globe Injury Levandi Mulja; Mayasari Wahyu; Irawati Irfani; Primawita Oktarima
Majalah Oftalmologi Indonesia Vol 48 No 2 (2022): Ophthalmologica Indonesiana
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/journal.v48i2.100669

Abstract

Introduction: Traumatic cataract is one of the leading causes of monocular blindness in children. The management of pediatric traumatic cataract is challenging; the growing size of the affected eyes and the risk of amblyopia further complicate things. The timing of cataract removal and IOL implantation remain controversial until today. Case Report: A thirteen-years-old boy came with his left eye punctured by a pencil tip. He came in with a visual acuity of 1/300, a full-thickness 5 mm paracentral corneal laceration and traumatic cataract. The patient went through a two-step surgery. Cataract surgery and IOL implantation was conducted one week following corneal laceration suture. Discussion: Two-step surgery was performed on this patient with consideration being cataract removal performed when the inflammation of the eye was subside and also a more accurate IOL calculation. One study stated, even with 43.4% of patient’s anterior capsule ruptures, it would postponed cataract surgery for 2 days up to 6 months. In this case, a week after first surgery, it revealed anterior capsule rupture and the lens material was touching corneal endothelium. Therefore, lensectomy was performed because it touches the corneal endothelium causing further damage Conclusion: The two-step procedure performed was a preferable surgery for a traumatic cataract in a quiet eye, because it has better potential for visual improvement and IOL calculation. However, since the anterior lens capsule ruptured and the lens material prolapsed into the anterior chamber, it would have been even better to perform lensectomy as an early procedure to prevent inflammation.
COMPARISON OF ANGLE OPENING DISTANCE AND TRABECULAR IRIS SPACE AREA BEFORE AND AFTER LASER PERIPHERAL IRIDOTOMY IN ANGLE CLOSURE DISEASE: Abstract Only Rizki Fasa Ramdhani; R. Maula Rifada; Irawati Irfani; Elsa Gustianty; Sonie Umbara
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/p64vmm95

Abstract

Introduction and Objective: Laser peripheral iridotomy (LPI) is the standard first-line therapy in angle closure disease to increase anterior chamber angle width. Spectral Domain Anterior Segment Optical Coherence Tomography (SD AS-OCT) is an instrument that has a quantitative parameter to measure anterior chamber angle. Angle opening distance (AOD) and trabecular iris space area (TISA) are quantitative parameters in SD AS-OCT. The purpose of this study is to compare AOD and TISA before and one week after LPI in angle closure disease. Methods: This is an analytical prospective study with a cross-sectional study design. Twenty-two eyes with angle closure disease that met inclusion and exclusion criteria underwent LPI and SD AS-OCT before and one week after LPI. Analysis was performed using SD AS-OCT parameters, such as AOD (AOD500, AOD750) and TISA (TISA500, TISA750) in the temporal, nasal quadrants, and average. Results: Twenty-two eyes with angle closure are divided into nine eyes with primary angle closure suspect, seven eyes with primary angle closure, and six eyes with primary angle closure glaucoma. The mean age of participants was 57.86±7.63 years. There was a significant increase in AOD500, AOD750, TISA500, and TISA750 in the temporal and nasal quadrants, as well as in the average (P=0.0001) based on a paired t test or Wilcoxon as an alternative. Average AOD750 had the highest T-value (T= 6.329) with a mean 0.20±0.096 before LPI and 0.31±0.144 one week after LPI. Conclusion: There was a significant increase in AOD and TISA after one week LPI in angle closure disease.
COMPARISON OF ANGLE OPENING DISTANCE AND TRABECULAR IRIS SPACE AREA BEFORE AND AFTER LASER PERIPHERAL IRIDOTOMY IN ANGLE CLOSURE DISEASE: Oral Presentation - Observational Study - Resident Rizki Fasa Ramdhani; R. Maula Rifada; Irawati Irfani; Elsa Gustianty; Sonie Umbara
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: 10.35749/05vxs382

Abstract

Introduction & ObjectivesLaser peripheral iridotomy (LPI) is the standard first-line therapy in angle closure disease toincrease anterior chamber angle width. Spectral Domain Anterior Segment Optical CoherenceTomography (SD AS-OCT) is an instrument that has a quantitative parameter to measure anteriorchamber angle. Angle opening distance (AOD) and trabecular iris space area (TISA) are quantitativeparameters in SD AS-OCT. The purpose of this study is to compare AOD and TISA before and oneweek after LPI in angle closure disease. MethodsThis is an analytical prospective study with a cross-sectional study design. Twenty-two eyes withangle closure disease that met inclusion and exclusion criteria underwent LPI and SD AS-OCT beforeand one week after LPI. Analysis was performed using SD AS-OCT parameters, such as AOD(AOD500, AOD750) and TISA (TISA500, TISA750) in the temporal, nasal quadrants, and average. ResultsTwenty-two eyes with angle closure are divided into nine eyes with primary angle closure suspect,seven eyes with primary angle closure, and six eyes with primary angle closure glaucoma. The meanage of participants was 57.86±7.63 years. There was a significant increase in AOD500, AOD750,TISA500, and TISA750 in the temporal and nasal quadrants, as well as in the average (P=0.0001)based on a paired t test or Wilcoxon as an alternative. Average AOD750 had the highest T-value (T=6.329) with a mean 0.20±0.096 before LPI and 0.31±0.144 one week after LPI. ConclusionThere was a significant increase in AOD and TISA after one week LPI in angle closure disease.
CHALLENGES IN THE SURGICAL MANAGEMENT OF BILATERAL POSTERIOR LENTIGLOBUS: Poster Presentation - Case Report - Resident SYIFA RAHMANI; Feti Karfiati Memed; Sesy Caesarya; Primawita Oktarima Amiruddin; Irawati Irfani; Mayasari Wahyu Kuntorini
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/awdxnd05

Abstract

Introduction : Lentiglobus is a lens deformation characterized by spherical bulging of the lens surface. The weakness of the posterior capsule in the lentiglobus makes the surgery challenging. We present a case of bilateral posterior lentiglobus and its management. Case Illustration : A 5-year-old boy was presented with the chief complaint of gradually blurred vision since 1 year ago. Visual acuity were 0.1 and closed face finger counting in the right and left eyes, respectively. An ophthalmology examination revealed lens opacities with partially reabsorbed lens material and protrusion of the lens surface posteriorly in both eyes (figure 1). The patient was diagnosed with developmental cataracts of the membranous type and posterior lentiglobus in both eyes. The patient underwent a surgical intervention for cataract extraction with aspiration technique. A spontaneous posterior capsule rupture was found with a shape like a lentiglobus. An anterior vitrectomy was performed. An intraocular lens was implanted. At one month after surgery, the best corrected visual acuities were 0.5 in both eyes (figure 2). Discussion : Several difficulties can be encountered during pediatric cataract surgery with the posterior lentiglobus morphology because of the thin or ruptured capsule. Previous studies have found preoperative and intraoperative posterior capsule rupture in 25% and 3.13% of lentiglobus cases, respectively. Hydrodissection should be avoided due to the weakness of the posterior capsule. ConclusionAppropriate surgical techniques to anticipate posterior capsule defects in the lentiglobus are required to produce a favorable outcome.
SUCESSFULL MANAGEMENT OF CHILDHOOD BASIC-TYPE ESOTROPIA IN ADULT PATIENT: Poster Presentation - Case Report - Resident ANISA VITRIANA; Feti Karfiati M.; Sesy Caesarya; Primawita O. Amiruddin; Mayasari Wahyu Kuntorini; Irawati Irfani
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/b62wcv21

Abstract

Introduction : Strabismus in adults may indicate other pathological causes, such as neurological disorders or trauma. Diagnosis of esotropia in adult patients has to be made carefully to determine the right treatment. Management’s goal of strabismus in adult patients is mainly cosmetic by diminishing deviation. Case Illustration : A 46-year-old woman, complaint of inward deviation of both eyes since childhood. There were no complaints of double vision, headaches, nor trauma history. Visual acuity of right eye was 0.4 with BCVA and left eye was 0.8 with BCVA 0.8. Hirschberg test was 45o (Figure 2A). Prism cover test was 75 PD base out in near and distance. Patient was diagnosed with basic-type esotropia. The patient already given spectacles but the deviation persisted so she underwent bilateral medial rectus recess surgery (Figure 2B). Ocular alignment without spectacles 1 week after surgery showed orthotropia and small esophoria. (Figure 2C). Discussion : Each esotropia types has a different treatment approach. Basic-type esotropia with large deviation usually needs surgical treatment. Management of childhood onset strabismus in adult patients is challenging because those patients have lesser ability to maintain fusion. Older patients and large deviation are poor prognostic factors to achieve good functional and cosmetics outcome after strabismus surgery. Conclusion : Establishing a definite diagnosis in adult strabismus patients, including esotropia, is challenging. Careful diagnosis and management decision will determine the outcome of the patient’s condition.
Augmented Surgical Treatment in Patient with Partially Accomodative Esotropia: Poster Presentation - Case Report - Resident PRADISTYA SYIFA YUDIASARI; Feti Karfiati; Mayasari Wahyu Kuntorini; Irawati Irfani; Primawita Oktarima; Sesu Caesarya
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: 10.35749/04zm5t36

Abstract

Introduction : Esotropia is a disorder of the position of the eyeball when the eye deviates inward. Surgical treatment is indicated when the eyes are not aligned with the glasses. We report a case of augmented surgical treatment in a partially accommodative esotropia patient. Case Illustration : A 18-year-old girl comes to the hospital with vision loss in both eyes since 1 year prior admission. Ocular alignment sinne correction was 300 (Figure 1) and cum correction was 150. Prism alternate cover test (PACT) showed deviation in sinne correction distance 60?BO dan near 50?BO, and deviation in cum correction distance 40?BO dan near 35?BO. Surgical formula with augmented surgery was (60?BO + 40?BO)/2 equal to 50?BO. Patient was diagnosed with Compositus Hypermetropia ODS + Partially Accommodative Esotropia. Patient underwent bilateral medial rectus recess surgery of 6 mm. Ophthalmology examination after 1 and 2.5 month surgery showed ocular alignment without spectacles showed microtropia and with spectacles showed orthotropia (Figure 2, 3a and 3b). Discussion : Various approaches can improve outcomes, including using different surgical formulas. Augmented surgery are the mean of deviation with and without surgery as the final deviation surgical formula. Conclusion : The amount of surgery in strabismus was based on the size of preoperative deviation. Augmented surgical treatment can be one of the choices to determine preoperative deviation in an esotropia patient.
Sympathetic Ophthalmia in Paediatric Post-Surgical Repair, A Case Report: Poster Presentation - Case Report - Resident Muhammad Akbar Wicaksana; Irawati Irfani; Mayasari Wahyu Kuntorini; Sesy Caesarya; Feti Karfiati; Primawita O. Amiruddin
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/z5apmh49

Abstract

Introduction : Sympathetic Ophthalmia (SO) is a rare and devastating complication of ocular trauma. Incidence reached 0.26% among cohort in paediatric open globe injury. We present a case report of pediatric Sympathetic Ophthalmia. Case Illustration : An 8-year-old boy is present in an outpatient clinic with a history of corneal lacerating injury on LE 1 month ago and had surgical repair 7 days after the injury. The patient complained of redness and blurry vision in both eyes. VA RE 0.5 and LE 0.05. RE revealed ciliary injection, flare/cell (f/s) +2/+2, and vitreous cell +1. LE revealed ciliary injection, corneal scars, f/s +2/+2, and vitreous cell +2 (Fig. 1). Fundus and OCT revealed macular oedema with exudative retinal detachment RE and bilateral optic nerve head swelling (Fig. 2). Patient was diagnosed with sympathetic ophthalmia and treated with prednisolone acetate 8x per day for RLE with high-dose oral steroid methylprednisolone 1 mg/kg body weight (32 mg). One week after treatment, clinical findings were improved, and the steroid was tapered. After 2 months f/s, macular oedema, exudative retinal detachment and optic nerve head swelling were resolved with VA RE 1.0 and LE 0.4. Discussion : Although the etiology of SO is currently unknown, it is believed that hypersensitivity following trauma to the fellow eye may be the trigger. The severity of SO's clinical presentation might range from mild to severe. Conclusion : Sympathetic ophthalmia is a serious complication that rarely occurs after trauma, especially in the pediatric population. Prompt treatment of oral and topical corticosteroids may lower the inflammatory response.
MANAGEMENT OF RECURRENT INTRAOCULAR LENS SUBLUXATION AFTER IOL REPOSITION IN APHAKIC PEDIATRIC PATIENT WITH SECONDARY GLAUCOMA AND DEPRIVATIVE AMBLYOPIA: Poster Presentation - Case Report - Resident INDRIYANI; Primawita O. Amiruddin; Sesy Caesarya; Irawati Irfani; Mayasari Wahyu Kuntorini; Feti Karfiati M
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: 10.35749/12mdey33

Abstract

Introduction : Malposition of the intraocular lens (IOL) can be in the form of decentration, subluxation, dislocation, or luxation. Conservative management and surgery are used to treat IOL subluxation. Case Illustration : A 14-year-old boy came to clinic with chief complaint of diplopia since 1 month ago. There were histories of cataract surgery of both eyes in 2014 and 2015 at a secondary hospital, secondary IOL implantation and membranectomy of right eye in December 2017, and IOL reposition of right eye in February 2022. Ophthalmologist examination revealed BCVA of right eye is 0.5 with S+10.00 C-2.25 x180 and left eye is 1/300. The right eye's intraocular pressure was 23 mmHg and the left eye's was 16 mmHg. Anterior segment examination of the right eye showed aphakia with subluxation of the IOL to the inferotemporal (Figure 1) and PC IOL of the left eye. Patient diagnosed with aphakia ODS with IOL subluxation OD, secondary glaucoma OD, astigmatisma Hypermetropia composite OD, astigmatism Myopia Compositus OS, Hypermetropia OD, Myopia Gravior OS, Deprivative Amblyopia ODS, and Last Eye OD. Patient given monofocal spectacles, prednisolone asetat eye drop tapering dose, and timolol maleate eye drop, with observation of IOL position Discussion : Recurrent IOL subluxation without clear signs of zonular or capsular instability in this patient was managed with conservative management using spectacles and medication due to secondary glaucoma. Long-term observation needed to evaluate possibility of repositioning or explanting the IOL in the future. Conclusion : Management of IOL subluxation could temporarily undergo conservative treatment. A surgical approach is considered in cases of recurrent dislocation
Co-Authors ANDIVAN RAHMAN ANISA VITRIANA Astrid Feinisa Khairani Astrid Feinisia Khairani Budiman Budiman Elsa Gustianty Elvita Marer Eva Imelda Feti Karfiati M Feti Karfiati M. Feti Karfiati Memed Indri Nurul Badriyah Indri Nurul Badriyah, Indri Nurul Indriyani Khairani, Astrid Feinisa Levandi Mulja Lulu Eva Rakhmilla Lulu Eva Rakhmilla, Lulu Eva Maya Sari Wahyu Mayasari Wahyu Mayasari Wahyu Kuntorini Muhammad Akbar Wicaksana Nina Ratnaningsih Pradistya Syifa Yudiasari Primawita O. Amiruddin Primawita Oktarima Primawita Oktarima Amiruddin R. Maula Rifada Raisha Pratiwi Indrawati Ramadanti, Sarah Nurul Rizki Fasa Ramdhani Sarah Nurul Ramadanti Sarah Nurul Ramadanti Sesu Caesarya Sesy Caesarya Sesy Caesarya Sonie Umbara Sri Hardwiyani Syifa Rahmani