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All Journal BALI MEDICAL JOURNAL (BMJ) Medicina E-Jurnal Medika Udayana Paediatrica Indonesiana ISM (Intisari Sains Medis) : Jurnal Kedokteran Indonesian Journal of Clinical Pathology and Medical Laboratory (IJCPML) Ophthalmologica Indonesiana
N. K. Niti Susila, N. K.
Bagian SMF Mata Fakultas Kedokteran Universitas Udayana
Biochemistry, Genetics & Molecular Biology Health Professions Medicine & Pharmacology Neuroscience Public Health

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Journal : Medicina

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CRYOTHERAPY PADA DESCEMETOCELE REKUREN POST-PERIOSTEAL GRAFT : LAPORAN KASUS PADA KERATOKONJUNGTIVITIS GONOKOKUS Yenny K, Nyoman; Susila, NK Niti; Budayanti, Nyoman Sri
Medicina Vol 46 No 3 (2015): September 2015
Publisher : Medicina

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Abstract

Keratokonjungtivitis gonokokus disebabkan oleh Neisseria gonorrhoeae, kokus gram negatif yangmenginvasi epitel kornea intak menyebabkan keratolisis stroma kornea hingga perforasi. Membrandescemet merupakan barrier terhadap mikroorganisme, namun ketika ditembus oleh mikroorganisme,akan  menonjol ke depan membentuk descemetocele. Dilaporkan satu kasus descemetocele padakeratokonjungtivitis gonokokus pada wanita usia 45 tahun di Rumah Sakit Umum Pusat SanglahDenpasar. Penderita mengeluh pandangan buram, kotoran mata kekuningan, kental sejak 6 hari,kelopak mata bengkak dan bintik hitam di mata kanan. Tajam penglihatan mata kanan 5/60.Pemeriksaan oftalmologi pada mata kanan didapat udem palpebra , konjungtiva sekret mukopurulenmasif, conjunctival vascular injection dan pericorneal vascular injection, udemkornea dan descemetoceledi jam 1, ukuran  3x2 mm, bilik mata depan dangkal dan fibrin, iris retraksi, pupil ireguler dan reflekpupil negatif, lensa tertutup fibrin, vitreus sulit dievaluasi, reflek fundus positif. Pada penderita telahdilakukan periosteal graft namun flap bergeser sehingga dilakukan tindakan ulangan cryotherapy yangmemberikan hasil baik. [MEDICINA 2015;46:184-8]Gonococcus keratoconjunctivitis caused by Neisseria gonorrhoeae, a gram-negative coccus thatinvading intact corneal epithel causing keratolysis until perforation. Descemet membrane is a barrierfor microorganism, but when penetrated by microorganism, it will bulging forming descemetocele.Wereported a case descemetoceleon gonococcus keratoconjunctivitis of a 45 years old woman in SanglahHospital-Denpasar.Patient complained blurry vision, white-yellowish secrete, purulent since 6 days,palpebra edema, and black dot on right eye. Right eye visual acuity was 5/60. Ophthalmologyexamination of palpebra was edema, massive conjunctival mucopurulene secrete, conjunctival vascularinjection, pericorneal vascular injection, corneal edema, and descemetocele at 1o’clock hour, size 3x2mm, shallow anterior chamber and fibrin, iris retracted, irregular pupil, negative pupil reflex, fibrincovered by lens, can not evaluated vitreous, funduscopy reflex positive.Patient had been treated withgraft periosteal but then the flap was sliding, so we treated patient with cryotherapy and gave goodresult. [MEDICINA 2015;46:184-8].
Co-Authors A. A. Mas-Putrawati Alexander Theodore Samosir Anak Agung Gde Arisena Asmara Anak Agung Mas Putrawati Triningrat Cokorda Istri Dewiyani Pemayun H. S. Habiba Muhiddin, H. S. Habiba Hendra Santoso I Gusti Ayu Made Juliari I Ketut Suastika I Made Bakta I Made Gede Dwipayana Putra I Made Surya Dinajaya I Nyoman Wande I Wayan Putu Sutirta Yasa Ida Ayu Ary Paramita Ida Ayu Ary Pramita Kadek Ayu Dorinda Sari Komang Putra Tridiyoga Made Agus Kusumadjaja Made Sukmawati Ni Nyoman Sri Budayanti Nyoman Yenny K, Nyoman Putu Budhiastra Putu Budhiastra Putu Budhiastra Sianny Herawati