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Successful Management of Cataract in Patient With Long Anterior Zonules and Small Pupil :A Rare Case: Poster Presentation - Case Report - Ophthalmologist Riskha Pangestika; Rio Rhendy; Syska Widyawati
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/e9shxj46

Abstract

Introduction : Long anterior zonules (LAZ) are rare disease with prevalence was 1–2%, characterized by zonular fibers that extend centrally leading to a small zonule-free zone (ZFZ), which raises the risk of complications during zonular cutting while continuous curvilinear capsulorhexis (CCC). This leads to two options whether to perform phacoemulsification through a small CCC within the small ZFZ or an adequately sized CCC. The objective of this study was to report challenging management of phacoemulsification surgery with LAZ eyes with small pupil Case Illustration : A 62 y.o female had visual acuity(VA) 0.7(logMAR) due to corticonuclear cataract in left eye. She had history complicated cataract surgery with secondary sulcus fixated IOL in her fellow eye. The IOP was normal, no phacodenesis and pseudoexfoliative material observed in left eye. The posterior segment was normal. The left eye observed otherwise normal in initial examination. Intraoperatively, after viscomidriasis technique the ZFZ identified in the area of 2.0-2.5 mm from central. Five millimeter CCC can be achieved in the central area and phacoemulsification with the help of CTR (Capsular Tension Ring) safely performed and one piece IOL was implanted in the bag. Discussion : On the first postoperative day, VA was improves to 0.4(logMAR), IOL central and clear corneal with minimal inflammation. One week after surgery, the VA 0.3(logMAR) and no sign of IOL decenteration. Conclusion : Phacoemulsification in eyes with LAZs can be safely performed with CTR through an adequately sized CCC without significant complications. A combination of early recognising high-risk eye, proficient skills, and surgical instruments can improve outcome.
A Mystery Unsolved: A Spontaneous Lens and Uveal Prolapse in a New-born: Poster Presentation - Case Report - Resident NABILA ALJUFRI; Shafiq Advani; Dany Petra; Agnesstacia Vania L; Yulia Aziza; Julie D Barliana; Rio Rhendy
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: 10.35749/00a4a776

Abstract

Introduction : Corneal rupture in new-born, especially during the first week of life is rare. Some of these cases occur because of ocular trauma during deliveries, systemic infection, and congenital anomalies. We aim to deliver a rare case of spontaneous lens and uveal prolapse in new-born and management in treating the case. Case Illustration : A-2-day-old full-term-baby was referred due to bleeding of the right eye 6 hours post-partum by spontaneous vaginal delivery with no trauma. The mother, a 23-year-old, having the second born with no history of medical illness or vaginal discharged during pregnancy. Measurements of birth weight and length were normal. Eye examination of the right eye (RE) was uveal and lens prolapse and left eye (LE) cloudy cornea with leukoma and prominent neovascularization. Orbital CT-Scan revealed bilateral vitreous bleeding of both eyes. Laboratory examination showed reactive IgM for herpes simplex virus, reactive IgG for both toxoplasma and rubella. Corneal swab culture was sterile. Systemic and topical antibiotics were administered then switched to systemic antivirus. The 12-day-old-patient showed partial epithelization of cornea, less uveal volume with it partially shrank. Close observation was conducted and evisceration was postponed. Discussion : Although etiologic work-up has been addressed, exact etiology remains unknown with the possibility of congenital cause. It has been postulated that structurally malformed eyes are more prone to corneal perforations. Management should be personalized based on the patient’s need. Conclusion : Thorough examination is vital a rare case with undisclosed aetiology especially new-born. Patient monitoring is sufficient if no infections and bleedings found.
Imaging Mismatch of Nail in the Eyeball: What’s next? Poster Presentation - Case Report - Resident Christella Caroline; Gladys Kusumowidagdo; Burhana Mawarasti; Michael Hartono; Julie Dewi Barliana; Rio Rhendy; Yunia Irawati; Ari Djatikusumo
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: 10.35749/2payky76

Abstract

Introduction : A retained foreign body (FB) can lead to severe complications, the most devastating of which is eye loss. We present a discrepancy of imaging that resulted in a dilemma in the approach management of a mixed global-adnexal FB case. Case Illustration : A 31-year-old man came to the emergency room with blurry vision for 1.5 hours after a nail hit his right eye (RE). The visual acuity of RE is light perception. Ophthalmological examination revealed a central Y-shaped full-thickness corneal laceration with iris and vitreous prolapse. The lens appeared cloudy, and the posterior segment was difficult to assess. Imaging showed a foreign metal object asa nail in the oculi to intraconal without penetration to the orbital wall. He was planned to undergo FB extraction with corneal laceration repair and aspiration of lens mass irrigation. However, the nail was hard to find intraoperatively because the vitreous and choroid kept coming out. Hence evisceration with DFG was performed. The nail was found more posteriorly and attached to the bone. Discussion : While primary repair is the standard practice for open globe injury, managing retained intraocular metallic foreign bodies is controversial. Imaging such as CT scans can help determine the location of FB and approach management. In this case, imaging showed the FB was in the iris plane and not penetrating the orbital wall, so primary repair and FB extraction were planned. Conclusion : The imaging may not always be accurate in determining the exact location of FB, and the surgical approach may need to be adjusted accordingly.