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R Maula Rifada
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Health Professions Medicine & Pharmacology Public Health

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SELECTIVE LASER TRABECULOPLASTY AS A VALUEABLE MODALITY OF TREATMENT IN OPEN ANGLE GLAUCOMA PATIENT: Oral Presentation - Observational Study - Ophthalmologist DYAH PURWITA TRIANGGADEWI; Sonie Umbara; R Maula Rifada; Elsa Gustianty; Andika Prahasta
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/r6cq3b33

Abstract

Introduction & ObjectivesSelective Laser Trabeculoplasty (SLT) has became an established treatment to lower intraocularpressure (IOP) for open angle glaucoma (OAG) and ocular hypertension. The aim of this study was toevaluate IOP lowering effect of SLT and correlate its laser parameter to the successful rate in OAG. MethodsThis is a prospective study of seventeen eyes OAG patients in Cicendo Eye Hospital from 1stNovember 2022 to 31th December 2022. SLT performed once in OAG with uncontrolled IOP (IOP >21 mmHg). Outcome measured were IOP at post laser, 1week , 1 month, and 2 months of follow upafter SLT. Successful criteria determined as greater than 20% IOP reduction. Correlation betweensetting operational of SLT and primary outcome were measured. Student’s t-test (two-tailed,dependent) has been used to find the significance of study parameters. ResultsA total 17 eyes underwent SLT. Mean baseline IOP was 21,12 ? 4,0 mmHg. IOP was significantlydecreased from baseline post laser 18,06 ? 3,17 mmHg; at 1 week 17,06 ? 3,25 mmHg; 1 month15,53 ? 4,52 mmHg; and at 2 month follow up 15,47 ? 4,02 mmHg (p<0,001). The successful rate ofSLT after two months follow up from this study were 76,5% samples (13 eyes). Mean of total laserenergy was 75,6 ? 16,8 mJ. There was correlation between total laser energy with percentage of 1month IOP reduction (coefficient : 0,470 (p<0,029)). ConclusionSLT is effective and safe for reducing IOP in open angle glaucoma patient.
ACETAZOLAMIDE INDUCED SECONDARY ANGLE CLOSURE GLAUCOMA: A RARE CASE REPORT: Poster Presentation - Case Report - Resident Siti Mutia Atisundara; R Maula Rifada; Sonie Umbara; Elsa Gustianty; Andhika Prahasta
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: 10.35749/5mw96e77

Abstract

Introduction : Drugs such as topiramate, acetazolamide, methazolamide, buproprion, and trimethoprim- sulfamethoxazole potentially cause an elevation of IOP. Drug-induced glaucoma may be an ophthalmic emergency if not treated promptly and can results in permanent visual loss. Case Illustration : A 36-years-old female came to Glaucoma Unit at Cicendo National Eye Hospital with progressive blurred vision since 1 year ago, worsening in the past six months. Accompanying symptoms included pain, headache, halo, and conjunctival hyperemia. She had been diagnosed with glaucoma and received timolol maleate, acetazolamide, and glycerin. Seven days later, her visual acuity worsened to 3/60 ph 0.15 RE and 2/60 ph 0.15 LE, with high IOP in both eyes, with the higher IOP being >30 mmHg. The cup-to-disc ratio was 0.3 RE and 0,8 LE. The anterior segment showed shallow anterior chamber, mid-dilated pupil, and conjunctival injection (Figure 1.). Gonioscopy examination showed Schwalbe line of both eyes (Figure 2.). Acetazolamide was stopped, and one week later the condition resolved (Figure 3.). Discussion : Secondary angle closure glaucoma caused by acetazolamide is important to consider because most people tolerate acetazolamide well. The mechanism of closed-angle glaucoma can be pupillary block and non-pupillary block. Non-pupillary block is caused by thickening, forward movement the iris-lens diaphragm, rotation of the ciliary body, and choroidal effusion. This process is an idiosyncratic reaction to certain systemic drugs. Conclusion : Few cases were reported about secondary bilateral angle closure glaucoma due to acetazolamide. Treatment of angle closure glaucoma involves stopping acetazolamide
One-Step Surgical Approach for Treating Lens-Induced Glaucoma with Iridodialysis Following Blunt Trauma: Poster Presentation - Case Report - Resident Aditia Apriyanto Haryono; Elsa Gustianty; R Maula Rifada; 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/g56hfd75

Abstract

Introduction : Traumatic glaucoma is one of secondary glaucoma that can be challenging to treat. Blunt trauma to the eye may result in iritis, hyphema, lens subluxation, or dislocation leading to increased intraocular pressure (IOP). Every complication needs to be addressed promptly. Here we present about one-step surgical approach to treat lens indued glaucoma with iridodialysis following blunt trauma. Case Illustration : A 65-year-old man presented with a chief complaint of blurred vision and pain in his right eye for a month following blunt ocular trauma where he was hit with piece of wood while operating a chainsaw. Ophthalmologic examination revealed RE VA of 2/60 with IOP 32 mmHg. Anterior examination revealed a shallow anterior chamber, iridodialysis 90 degrees, cloudy lens with phacodonesis (Fig 1). Patient was diagnosed with lens-induced glaucoma, lens subluxation, iridodialysis and traumatic cataract. Patient was treated with antiglaucoma agents prior to surgery. One-step surgical approach: trabeculectomy, phacoemulsification with capsular tension ring, and iridodialysis repair become the treatment of choice (Fig 2). After one month of surgery, IOP decreased to 16 mmHg without anti-glaucoma medication, final VA RE achieved 0.2 (Fig 3).DiscussionManagement of traumatic glaucoma depends on the underlying cause of increased IOP. Trabeculectomy combined with lens extraction should be considered with degree of subluxation that may cause pupillary block. Repair iridodialysis can be done using various techniques. Conclusion : Management of traumatic glaucoma can be done with trabeculectomy, lens extraction and repair iridodialysis in one-step surgery. Surgical technique should be considered depending on the patient’s eye condition.
Co-Authors Aditia Apriyanto Haryono Andhika Prahasta Andika Prahasta DYAH PURWITA TRIANGGADEWI Elsa Gustianty Siti Mutia Atisundara Sonie Umbara