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All Journal Ophthalmologica Indonesiana
Faraby Martha
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Health Professions Medicine & Pharmacology Public Health

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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 Lia Amanda; Syska Widyawati; Faraby Martha; Jessica Zarwan
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.
Tenon Patch Graft in The Management of Corneal Perforations: A case series: Poster Presentation - Case Series - General practitioner Amirah Deandra Diba; Faraby Martha
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.
Comparison of Visual Acuity and Defocus Curve after Cataract Surgery with Pure Extended Depth Focus Lens and Mini-Monovision - Interim Analysis -: Oral Presentation - Experimental Study - Resident M. Dio Syaputra; Syska Widyawati; Faraby Martha; Tri Rahayu; Aria Kekalih
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: 10.35749/4qer8x86

Abstract

Abstract Introduction & Objectives : Presbyopia after cataract surgery is still a problem despite recent surgical techniques and intraocular lens technology development. Mini-monovision techniques and pure extended depth of focus (EDoF) lenses are alternatives to achieve good distance and intermediate visual acuity at relatively inexpensive.This study aims to compare the clinical outcome after cataract surgery with binocular mini-monovision and cataract surgery using a pure monocular EDoF lens. Methods : Subjects were randomized into the mini-monovision group (standard monofocal lenses with -1.25 D of anisometropia) and the pure EDoF group. The blinding was achieved by masking the clinical outcome examiners. Results : Interim analysis of 16 patients revealed the outcome of uncorrected and corrected distance visual acuity (UCDVA and BCDVA) were not significantly different between groups. Median of uncorrected intermediate visual acuity (UIVA) and mean of uncorrected near visual acuity (UNVA) of binocular mini-monovision were 0.10 (0-0.10) LogMar and 0.26 + 0.12 LogMar. Median UIVA & mean UNVA monocular EDoF were 0.19 (0.14-0.50) LogMar and 0.54 + 0.11 LogMar, respectively. The Mann- Whitney U test of UIVA between groups revealed p=0.001, and the unpaired T-test of UNVA revealed p=0.000. Mean defocus curve of -2.50 D lens were 0.31 LogMar in binocular mini- monovision group and 0.51 LogMar monocular in EDoF group (p=0.019). Conclusion : UIVA, UNVA and defocus curve of -2.50 D lens in the mini-monovision group were better than the EDoF group.
Validity and Reliability of Farra Eye Model as a Surgical Simulator for Capsulorhexis Training: Oral Presentation - Observational Study - Resident HANIFAH RAHMANI NURSANTI; Julie Dewi Barliana; Syska Widyawati; Faraby Martha; Levina Chandra Khoe
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/w12r3545

Abstract

Abstract Introduction & Objectives : Various simulation models are available for cataract surgery training. Farra Eye Model, a new cataract surgery simulator, was developed to provide the resident with more affordable options. This study aims to determine the validity and reliability of the Farra Eye Model as a surgical simulator for capsulorhexis training. Methods : A cross-sectional pilot study was performed among ophthalmology residents and consultants to assess face, content, and construct validity of a new surgical simulator. Subjects were divided into novice, intermediate, and expert groups according to their level of expertise. Face and content validity was assessed using a validated questionnaire with a 5-point Likert scale response. Construct validity was done by comparing capsulorhexis performance between the three groups. Two raters assessed performance using capsulorhexis indices in ICO-OSCAR: Phaco assessment tool, number of forceps grabs, and duration of capsulorhexis. Results : A total of 33 subjects were recruited and divided equally into three groups. The overall face validity score was favorable (3.67 ± 0.67). However, the capsule elasticity was rated poor (2.73 ± 1.1) among the intermediate group. The content validity was favorable regarding the overall score (4.15± 0.58) and each assessment component. In the construct validity test, intermediate and expert groups showed better capsulorhexis performance than the novice group on all parameters (p<0.001), with good inter-rater reliability (ICC>0.7). Conclusion : Farra Eye Model has a good face and content validity for capsulorhexis training and is able to differentiate the novice group from intermediate and expert groups. However, it remains a challenge to replicate human lens capsule elasticity.
Co-Authors Amirah Deandra Diba Aria Kekalih HANIFAH RAHMANI NURSANTI Jessica Zarwan Julie Dewi Barliana Levina Chandra Khoe Lia Amanda M. Dio Syaputra Syska Widyawati Tri Rahayu