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Ophthalmologica Indonesiana
Published by Perhimpunan Dokter Spesialis Mata Indonesia
ISSN : 01261193     EISSN : 2460545X     DOI : 10.35749
Core Subject : Health,
Health Professions Medicine & Pharmacology Public Health
Ophthalmologica Indonesiana is an open accessed online journal and comprehensive peer-reviewed ophthalmologist journal published by the Indonesian Ophthalmologist Association / Perhimpunan Dokter Spesialis Mata (PERDAMI). Our main mission is to encourage the important science in the clinical area of the ophthalmology field. We welcome authors for original articles (research), review articles, interesting case reports, special articles, clinical practices, and medical illustrations that focus on the clinical area of ophthalmology medicine.
Arjuna Subject : Kedokteran - Ophthalmology
Articles 852 Documents
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Diabetes, Diabetic Retinopathy, and Intravitreal Injection as a Risk Factor of Posterior Capsular Rupture in Phacoemulsification Cataract Surgery :A Systematic Review and Meta Analysis: Oral Presentation - Observational Study - Ophthalmologist NI LUH PUTU NURINDAH SUKMAWATI; I Gusti Putu Eka Suryawan Widnyana
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/j91km823

Abstract

Abstract Introduction & Objectives : The risk of PCR in patients with diabetes and its sequential complication including diabetic retinopathy and Intravitreal Injection (IVI) was still under debate. This study was aimed to summarize the risk of diabetes, diabetic retinopathy, and intravitreal injection towards PCR events during phacoemulsification cataract surgery. Methods : A systematic literature search was performed up to March 2023 from the last 10 years publications using Medline and Cochrane library databases. Pooled odds ratios (ORs) and 95% confidence intervals (CIs) of diabetes, diabetic retinopathy, and IVI with PCR events were calculated using random-effects models. The quality of included studies was appraised using the Newcastle-Ottawa Scale. Results : Six studies about diabetes, six studies about diabetic retinopathy and seven studies about IVI were included in this meta-analysis. The pooled odds ratios of PCR in eyes with diabetes was 1.22 (95% CI: 1.16-1.28) I2 =0.0%, with the diabetic retinopathy patients was 1.23 (95% CI: 1.13-1.33) I2 =64.3%, and with prior IVI was 1.05 (95% CI: 1.03-1.08) I2 =51%. Conclusion : This meta-analysis emphasize that diabetes, diabetic retinopathy, and previous IVI significantly increase the risk of PCR on future phacoemulsification surgery. Further studies are needed to elucidate the underlying mechanism.
OUTCOMES COMPARISON AFTER SMALL INCISION LENTICULE EXTRACTION (SMILE) AND FEMTOSECOND-LASER ASSISTED IN SITU KERATOMILEUSIS (FS-LASIK) IN LOW-MODERATE MYOPIA PATIENTS: Oral Presentation - Observational Study - Resident ANDREAS LUKITA HALIM; Budiman; Mayang Rini; Andrew M. H. Knoch; Emmy Dwi Sugiarti; Ludwig Melino Tjokrovonco
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/c8rx5r49

Abstract

Abstract Introduction & Objectives : Uncorrected myopia is the leading cause of visual impairment globally. It can be corrected by refractive surgeries, such as Small Incision Lenticule Extraction (SMILE) and Femtosecond Laser- Assisted In Situ Keratomileusis (FS-LASIK). SMILE technique is less-invasive than FS-LASIK, characterized by all-in-one femtosecond laser and flapless procedure. Correction of low-moderate myopia requires a special concern because even slight decreased in visual quality may be noticed by the patients and affect their satisfaction. The purpose of this study to compare the refractive outcomes after SMILE and FS-LASIK in low-moderate myopia patients. Methods : This is a prospective analytical observational study that was conducted in a tertiary hospital in Indonesia. Four refractive outcome parameters (predictability, efficacy, safety, and stability) were assessed at 1 day, 1 week, and 1 month postoperatively. Results : SMILE was performed on 22 eyes with spherical equivalent (SE) -3.60±1.07 D and FS-LASIK on 20 eyes with SE -2.91±1.53 D. At 1 month, the predictability as the proportion of eyes within SE ±0.50 D were 95.5% in SMILE and 80% in FS-LASIK (p=0.174), the efficacy as the proportion of eyes achieving uncorrected distant visual acuity (UDVA) ≥20/20 were 63.6% in SMILE and 35% in FS- LASIK (p= 0.064), the stability as the proportion of eyes experiencing SE change >0.50 D were 4.5% in SMILE and 5% in FS-LASIK (p=1.000). No eyes from both groups had corrected distant visual acuity (CDVA) loss of ≥2 lines (p=1.000). Conclusion : SMILE and FS-LASIK were both predictable, effective, safe, and stable for low-moderate myopia patients.
The Effect of Limbal Relaxing Incisions on 1-Week Postoperative K1 and K2 Values: Oral Presentation - Observational Study - Resident Ilham Prayoga Bakhri; Wisnu Sudasih; Rizal Fanany
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/bzpa9735

Abstract

Abstract Introduction & Objectives : Limbal Relaxing Incisions (LRI) is a surgical technique used to correct astigmatism during cataract surgery. This technique used to reduce the steepness of the corneal curvature in a particular meridian. LRI can be performed alone or in combination with phacoemulsification. Methods : This prospective study aimed to investigate the effect of Limbal Relaxing Incisions (LRI) on corneal astigmatism in patients who underwent phacoemulsification cataract surgery. Five patients were included in this study, and preoperative and 1-week postoperative keratometry values (K1 and K2) were measured using the IOL Master. Paired t-test analysis was used to compare the changes in K1 and K2 values before and after LRI Results : Five eyes of Five patients with the mean age 39.8 years (range : 22 to 76 years) and corneal astigmatism 3.12 D (range : 2.25 to 4.66 D) were underwent LRI and cataract surgery. The mean preoperative K1 and K2 values were 42.12 D and 46.44 D, respectively, while the mean 1-week postoperative K1 and K2 values were 42.60 D and 45.80 D, respectively. Paired t-test analysis showed a statistically significant decrease in K2 values (p = 0.025) but no significant change in K1 values (p = 0.329). Conclusion : This study showed there were no significant difference between pre and postoperative of K1 and showed a significant decrease in K2 on IOL Master examination. The wide age range of the included patients, may have influenced the effectiveness of LRI in reducing astigmatism. Further study with more subject are required.
Transglutaminase-induced Cornea Collagen Crosslinking Effect on Central Corneal Thickness and Keratocyte Cell Density: Oral Presentation - Experimental Study - Ophthalmologist PUSPITA HAPSARI SITORASMI; Yuniar Sarah Ningtiyas; Indri Wahyuni; Yulia Primatasari
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/b8s0fh73

Abstract

Abstract Introduction & Objectives : This research is aimed to evaluate the effect of transglutaminase-induced corneal collagen crosslinking (CXL) on central corneal thickness (CCT) and keratocyte cell density in vivo. Methods : Twenty-eight white New Zealand rabbits were divided into four groups: the transglutaminase- induced CXL group, the epithelial-off CXL group, the transepithelial CXL group, and the control group. The ocular surface was treated with a 1 U/mL microbial transglutaminase solution, and both the epithelial-off and transepithelial groups were exposed to clinical ultraviolet A-riboflavin (UVA/RF). The efficacy of each group was evaluated on the 14th day after the procedures. Central corneal thickness was evaluated with Corneal Visualization Scheimpflug Technology (Corvis ST) and keratocyte cell density wad evaluated with histopathology examination. Results : Transglutaminase-induced CXL group exhibited the highest mean biomechanical CCT (370.14 ± 38.85) in comparison to the UVA/RF epithelial-off group (368.00 ± 25.48), the UVA/RF transepithelial group (369.86 ± 23.43), and the control group (365.14 ± 28.74). Still, there was no significant differences in both biomechanical CCT (p=0.990). Transglutaminase-induced CXL group had the highest mean of keratocyte cell density (43.26 ± 10.65) compared to UVA/RF epithelial-off (29.99 ± 4.79), UVA/RF transepithelial group (42.03 ± 6.55), and control group (34.36 ± 6.76). There was a significant difference between the group, with a p-value of 0.008. Conclusion : Transglutaminase shown that it produces favorable results for CCT and keratocyte density after CXL, which are two factors contributing to corneal rigidity. The outcomes are equivalent to riboflavin used as a conventional element in CXL.
Visual And Refractive Outcomes of Myopia Astigmatism After Small Incision Lenticule Extraction (ReLEx SMILE) Procedures; Retrospective Study: Oral Presentation - Observational Study - Ophthalmologist ANDI AKHMAD FAISAL; Nashrul Ihsan; Ucok P. Pasaribu; Vidyapati Mangunkusumo
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/a8wdcw27

Abstract

Abstract Introduction & Objectives : Small Incision Lenticule Extraction (ReLEx SMILE) is becoming more popular as a flapless and minimally invasive form of laser vision correction for the treatment of myopia and myopia astigmatism. This study aimed to assess postoperative visual and refractive outcomes of SMILE- based correction of myopia astigmatism, to evaluate the efficacy, predictability, safety, and stabilityof this procedure over a one-month postoperative period Methods : This retrospective study evaluated 200 eyes of 100 patients who underwent ReLEX SMILE technique, using the Zeiss VisuMax Laser between July 2020 and October 2022. Before surgery, 1 day and 1 month after surgery, the efficacy, predictability, safety, and stability of the procedure were assessed. Results : The preoperative Mean Uncorrected Distance Visual Acuity (UCVA) was 1.55 ± 0.53. Corrected Distance Visual Acuity (BCVA) was 20/20 or better in 74.50% and 90% of eyes in 1 day and 1 month after surgery, respectively. MRSE reduced from -5.22 ± 2.44 to -0.22 ± 0.54 at 1 day post-operative, and -0.19 ± 0.51 at 1 month. 75% of eyes had an unchanged BCVA between 1 day and 1 month after surgery. 72% of eyes achieved spherical equivalent within ±0.5 D and 94% of eyes were within ±1.0 1 month after surgery. The intraoperative complication was suction loss in two patients. Conclusion : SMILE can be considered an effective and safe refractive surgery for the treatment of myopia astigmatism.
ESTIMATION OF ND:YAG LASER ENERGY FOR VARIOUS TYPES OF POSTERIOR CAPSULE OPACITY: Oral Presentation - Observational Study - Resident INTAN EKARULITA; Andrew M. H. Knoch; Feti Karfiati; Ludwig Melino Tjokrovonco; Emmy Dwi Sugiarti; Budiman
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: 10.35749/7fz1sf04

Abstract

Abstract Introduction & Objectives : Types of Posterior capsule opacity (PCO) are membranous, fibrotic, or fibro-membranous. Surgical capsulotomy has been replaced by Neodymium-doped Ytrium Aluminim Garnet (Nd:YAG) as a PCO management nowdays. The initial energy use of the laser is influenced by variations in PCO density. Utilizing initial energy effectively can help to use less total laser energy. This study is to estimate energy Nd:YAG laser levels to treat various types of PCO. Methods : This is a observational descriptive study with cross-sectional design. This study retrieved initial and total capsulotomy Nd:YAG laser as a main variable on various types of PCO. The best corrected visual acuity (BCVA) before and after laser, size of hole capsulotomy, and complications of each type of PCO were evaluated. Results : A total 59 eyes of 49 patients with pseudophakia who underwent capsulotomy laser were included. The mean values of initial energy levels were 1,45±0,31 mJ for membranous PCO, 1,51±0,29 mJ for fibrous PCO, and 1,68±0,23 mJ for fibro-membran PCO. The mean summated energy levels for membranous PCO was 51,86±28,19 mJ, 78,86±44,81 mJ for fibrous PCO, 86,88±60,51 mJ for fibro- membran PCO. Complications were iritis, oculi hypertension, hyaloid rupture and IOL pitting were occurred in this study. Conclusion : Fibro-membran PCO required more initial and total laser energy compared to membranous and fibrous PCO
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.
Comparison of Pain and Anxiety Scales in The First and Second Cataract Surgeries in Patient with Bilateral Cataract: Oral Presentation - Observational Study - Resident SARAH EISYA PUTRI; Ahmad Ashraf Amalius; Andi Akhmad Faisal; M. Irfan Kamaruddin
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/vfagfh36

Abstract

Abstract : Introduction & ObjectivesPain and anxiety in cataract surgery can be investigated as subjective experiences and satisfaction. This study was to evaluate and compare pain and anxiety scale reported by patients with bilateral cataract in the first and second surgery. Methods : This prospective study was based on patients in Jakarta Eye Centre Orbita Makassar between August-October 2022. Consecutive patients undergoing bilateral cataract surgery with the first and second surgery separated by minimum of two weeks with phacoemulsification method and used topical anaesthesia, by three surgeons. Patients with traumatic cataract, secondary cataract, and other ocular abnormality, also patients with intraoperative complications were excluded. Patients completed questionnaires of Numerical Rating Scale to evaluate pain and Amsterdam Preoperative Anxiety and Information Scale (APAIS) to evaluate anxiety divided into no, mild, moderate, severe, and very severe anxiety. Results : A total of 42 patients with an average of 64,5 years old were included. There were 2 (4.7%) patients reported more pain in the first surgery, 30 (71%) patients reported more pain in the second surgery, and 10 (23%) patients reported same pain between the first and second surgeries (p=0,000). Most patients reported mild anxiety in the first surgery and no anxiety in second surgery. Conclusion : Patients with bilateral cataracts reported more pain on the second surgery than the first surgery. The anxiety was reported more severe before and during the first surgery than the second surgery. This report can be used in giving informed concern and in the management of bilateral cataract surgeries consecutively.
Nuclear Grades based on Lens Opacities Classification System III associated with Phacoemulsification Parameters and Postoperative Central Corneal Thickness: Oral Presentation - Observational Study - Resident MARIA DEBORA NIKEN LARASATI; Dicky Hermawan; Indri Wahyuni; Dianawati Koesoemawardhani
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: 10.35749/53phk079

Abstract

Abstract Introduction & Objectives : To determine association of nuclear cataract grades based on Lens Opacities Classification System (LOCS) III with phacoemulsification parameters and postoperative Central Corneal Thickness (CCT) and visual acuity. Methods : This was a prospective observational study in patient with uncomplicated senile cataract who gave consent and underwent phacoemulsification. Institutional Ethics Committee clearance was taken for the study. Preoperative nuclear cataract was evaluated using Lens Opacities Classification System (LOCS) III. Only nuclear grading NO and NC was obtained. All procedures was performed using peristaltic phaco machine and in the bag IOL implantation. Phacoemulsification parameters (US Total Time and CDE) were noted and compared in different grades of cataract. CCT change was recorded at day one after surgery. Results : Forty-six patients were evaluated. The mean USTT was 120.85 (56-252) seconds, mean CDE was 21.10 (5.70 – 43.38), and mean CCT change after surgery was 81.54(27 – 240). Nuclear grading of LOCS also had linear correlation with US Total Time (NO p<0.001, r=0.734; NC p<0.001, r=0.790) and CDE (NO p<0.001, r=0.728; NC p<0.001, r=0.685). There was significant correlation between CCT change with postoperative VA (p=0.002, r=0.443) and CDE (p<0.001, r= 0.553). CCT change also correlate with nuclear opacity (p=0.012, r=0.367) and nuclear color (p=0.035, r=0.312). Conclusion : Nuclear grading of LOCS III related to the amount of time and energy used in phacoemulsification, and also CCT change after surgery as a qualitative measurement of corneal edema. Increasing postoperative CCT affected patient's visual acuity after cataract surgery.

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