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Dini Dharmawidiarini
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Health Professions Medicine & Pharmacology Public Health

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VISUAL OUTCOMES AND COMPLICATIONS OF IRIS-CLAW INTRAOCULAR LENS IMPLANTATION IN APHAKIC EYES WITH INADEQUATE CAPSULAR SUPPORT Faiz Nurboston Fauzi; Dini Dharmawidiarini; Farida Moenir; Sahata PH Napitupulu
Majalah Oftalmologi Indonesia Vol 49 No 1 (2023): 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.v49i1.100592

Abstract

Introduction: Aphakia with inadequate capsular support remains a challenge for ophthalmologist. Although there is no consensus on the best method for this case, many studies have been reported using iris claw intraocular lens for secondary implantation. Objective: To evaluate the various indications, visual outcomes, and complications of iris claw intraocular lens in aphakic eyes. Methods : This retrospective case study was conducted in Undaan Eye Hospital, Surabaya, collecting data from medical records with a total of 188 eyes of 186 patients between May 2017 and April 2020, that were rehabilitated with prepupillary and retropupillary fixation of an iris claw lens. Patients were followed-up to 9 months for visual acuity and complications. Results: The most common cause of aphakia was subluxation of lens (spontaneous, trauma or congenital) in 90 of the 188 eyes (47.3%). The mean follow-up was 3 months (range :1-9 month). Most patient had the best preoperative BCVA (0-0.50 logMAR) 63%, ranging 0-2.47 logMAR with a mean of 0.72 logMAR. At final follow up, of the total patients, 72.9 % had the BCVA of 0-0.5 logMAR, with a mean of 0.37 logMAR. Complication included secondary glaucoma 2.12%, uveitis 1.06 %, iridodyalisis 1.06 %, and bullous keratopathy 1.06%. Conclusion: iris claw IOL implantation is a safe and effective method of rehabilitating aphakic eye with inadequate capsular support.
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 Rizqi Suryani Putri; Dini Dharmawidiarini; Farida Moenir; Sahata P . H. Napitupulu
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.
Managing Iris Cysts with Surgical Excision: A Case Series: Poster Presentation - Case Series - Ophthalmologist Tigor Santoso Sitorus; Azzahra Afifah; Dini Dharmawidiarini; Farida Moenir; Sanata PH Napitupulu
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/bba0bz36

Abstract

Introduction : Iris cysts are uncommon iris tumors. Primary iris cysts are congenital and usually not detected until late into the first or second decade of life. Secondary iris cysts have history of trauma or intraocular surgery. Small and asymptomatic iris cysts should be monitored, whereas larger cysts require treatment as they cause complications. Case Illustration : Case 1 a 17-year-old teenager had blurred vision without prior intraocular trauma or surgery. Anterior segment examination of the left eye revealed an oval, light brown, and semi-translucent cyst. Case 2 a 15-year-old girl had blurred vision and enlarging white spot in right eye with history of penetrating ocular trauma. Patient had undergone immediate penetrating repair followed by combination of pupilloplasty and cataract surgery. Anterior segment examination of the right eye showed corneal scar and cystic lesion. Both cysts extended to corneal endothelium and were managed surgically. Discussion : Larger cysts, especially with complications, require cyst aspiration, laser therapy, injections of antiproliferative agents, or surgery. We decided to surgically aspirate and excised iris walls to remove both iris cysts which were vital to achieve good result. Post-operative periods were uneventful with no significant inflammatory reactions associated with the procedure. Conclusion : Different modalities, with varying degrees of success, have been reported for the treatment of iris cysts. Surgical intervention remains the last option which can give a good functional outcome with minimal inflammatory complications, especially when less invasive options do not seem feasible due to the extensive nature of the cyst.
Co-Authors Azzahra Afifah Faiz Nurboston Fauzi Farida Moenir Rizqi Suryani Putri Sahata P . H. Napitupulu Sahata PH Napitupulu Sanata PH Napitupulu Tigor Santoso Sitorus