Pendahuluan : Glaukoma sudut terbuka primer saat ini masih merupakan kasus utama yang menyebabkan morbiditas okular di negara berkembang. Glaucoma drainage device (GDD) merupakan salah satu penatalaksanaan operasi dalam menangani kasus glaukoma. Tindakan operasi GDD memiliki faktor resiko. Erosi pada implant di konjungtiva dan tube exposed merupakan komplikasi paling sering dalam tindakan operasi GDD. Tujuan : Untuk melaporkan kasus penatalaksanaan tube exposed glaukoma implant Presentasi Kasus : Seorang pria, 50 thn datang dengan keluhan tidak nyaman pada mata kanan. Pasien memiliki riwayat operasi glaukoma implant pada mata kanan 5 tahun yang lalu. Pada pemeriksaan opftalmologis mata kanan didapatkan tube exposed disertai dengan injeksi siliar. Pasien kemudian dilakukan penatalaksanaan untuk memperbaiki glaukoma implant dengan menggunakan graft sklera pada mata kanan. Kesimpulan : Tindakan operasi GDD menjadi salah satu tindakan yang biasa dilakukan untuk penatalaksanaan glaukoma , Tube exposed pada GDD dapat di tatalaksana dengan menggunakan graft sklera.

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Introduction: Glaucoma is one of the most common complications in uveitis. The surgical intervention has been known for a lower success rate in Uveitis Glaucoma (UG). However, it is still a treatment of choice when medical therapy no longer could control the intraocular pressure (IOP). This study aims to describe UG's demographic and clinical characteristics that received glaucoma surgery and the outcome. Methods: Medical records of UG patients that received glaucoma surgery in 2018-2019 were reviewed. Age, gender, type and etiology of uveitis, duration of uveitis, intraocular pressure (IOP), visual acuity, gonioscopy, ocular characteristic, previous surgery and laser, current surgery, and complication were studied. Success was defined as IOP ≤21 mmHg or reduction >20% from baseline and >6mmHg with or without medication. Failure is defined in the presence of surgery complication that leads to a change of IOP, uncontrolled IOP that needs additional surgery, and visual acuity becomes no light perception (NLP). Results: 48 patients (57 eyes) with UG underwent glaucoma surgery. The mean age was 47,23±14,62. Anterior uveitis was the most common type of UG, with a mean uveitis duration before surgery was 13,75±17,65 months. The mean initial IOP was 35,81±13,30 mmHg, at the final visit 15,09±3,36. The mean follow-up duration was 6,41±4,02 months. The overall partial success was 75,44% in one month, 67,74% in 6 months Conclusion: A decrease in IOP was found in all surgery interventions, including Glaucoma Drainage Device (GDD) implant, trabeculectomy with 5-Fluorouracil (5FU), and combined trabeculectomy cataract surgery with or without 5FU, and cyclodestructive laser surgery. There was a high percentage of successful surgery but many losses to follow-up eyes in a short follow-up period.

Pendahuluan: Glaukoma pada anak merupakan kondisi yang berpotensi menyebabkan kebutaan. Penatalaksanaan glaukoma uveitis sulit dan menantang karena banyak mekanisme yang terlibat dalam patogenesisnya. Tujuan: Untuk melaporkan karakteristik klinis dan penatalaksanaan glaukoma uveitis pada anak dengan sindrom Blau. Laporan Kasus: Anak laki-laki berusia 13 tahun datang ke Poliklinik Glaukoma RS Mata Cicendo dengan keluhan kedua mata buram sejak 4 tahun lalu. Pasien telah didiagnosis sebagai sindroma Blau. Keluhan disertai persendian bengkak di lengan dan lutut, kulit hipopigmentasi dan bersisik. Riwayat operasi trabekulektomi mata sebelah kiri. Pemeriksaan oftalmologi menunjukkan visus ODS 1/300, tekanan intraokular OD 34mmHg dan OS 40mmHg. Segmen anterior mata kanan terdapat keratopati pita, sinekia posterior 360o, sinekia anterior perifer, dan katarak. Pada mata kiri terdapat bleb pada konjungtiva bulbar, keratopati pita, sinekia posterior, iridektomi perifer, dan katarak. Pasien didiagnosis sebagai glaukoma uveitis ODS, sindrom Blau, katarak komplikata ODS, keratopati pita ODS. Pasien diterapi dengan tetes mata timolol maleat 0.5%, brinzolamide, metilprednisolon tablet, metotreksat pre operatif. Pasien menjalani trabekulektomi, 5FU, sinekiolisis, retraktor iris, membranektomi mata kanan. Satu tahun pasca operatif tekanan intraokular pasien terkontrol, OD: 19mmHg, OS: 28mmHg dengan pemberian tetes mata timolol maleat 0.5% dan brinzolamide. Kesimpulan: Tatalaksana glaukoma uveitis pada anak membutuhkan terapi multidisiplin yang agresif dalam mengontrol inflamasi, tekanan intraokular, dan terapi ambliopia untuk mempertahankan penglihatan.

AbstrakPemeriksaan fundus memerlukan akses visualisasi yang baik. Pada penderita diabetes melitus, pupil sulit lebar menggunakan obat pelebar pupil standar sehingga perlu ditambahkan agen pelebar pupil. Penelitian ini dilakukan di Rumah Sakit Mata Cicendo periode Januari sampai Juli 2014 menggunakan metode double masked rendomized cotrolled trial terhadap 64 mata dari 32 subjek penelitian yang telah didiagnosis menderita retinopati diabetika dengan tingkat yang sama antara mata kiri dan kanan. Dibuat larutan kombinasi campuran 10 mL tropikamid 0,5%/fenilefrin 0,5%, 10 mL fenilefrin 5% dan 10 ml 0,1% Na diklofenak (larutan I) dan campuran 10 mL tropikamid 0,5%/fenilefrin 0,5%, dan 10 mL fenilefrin 5% (larutan II). Setiap subjek mendapat salah satu larutan pada mata dan larutan yang lain pada sebelahnya secara acak. Dilakukan pemantauan dengan cara memotret pupil pada menit ke-15, 20, dan 25 pada kedua mata. Lebar pupil kedua kelompok perlakuan diukur dengan perangkat lunak khusus (image processing). Dari penenelitian terdapat perbedaan bermakna antara penggunaan larutan I dan larutan II dalam melebarkan pupil baik pada menit ke-15 (t=2,02; p=0,047), menit ke 20 (t=2,23; p=0,029), dan pada menit ke-25 (t=2,041; p=0,045). Larutan kombinasi fenilefrin, tropikamid, dan natrium diklofenak menghasilkan efek dilatasi pupil yang lebih baik dibanding dengan larutan kombinasi fenilefrin dan tropikamid saja pada kasus retinopati diabetes. [MKB. 2017;49(3):199-207] Kata kunci: Dilatasi pupil, natrium diklofenak, retinopati diabetika Effectiveness of Sodium Diclofenac Addition to Pupil Dilatation Agent on Diabetic Retinopathy Patients AbstractFundus examination requires good visualization of fundus. In diabetic patients, it is difficult for the pupil to dilate using the standard pupilarry dilating agent. To achieve proper dilation, special agents have to be added to the standard dilation agent. The study was conducted in Cicendo Eye Hospital from January to July 2014, using double masked randomized controlled trial to 32 patients (64 eyes) who were diagnosed as suffering from diabetic retinopathy with the same grade on both eyes. Eye drop solutions were developed beforehand by mixing 10 mL of 0.5% tropicamide/0.5% phenylephrine, 10 mL of 5% phenylephrine, and 10 mL of 0.1% diclofenac-natrium (solution I) and also by mixing 10 mL of 0.5% tropicamide/0.5% phenylephrine and 10 mL of 5% phenylephrine (solution II). Every subject received one drop of one solution on one eye and the other solution on the other eye in randomly fashion. The observation was performed by taking photographs of the pupil on both eyes 15, 20, and 25 minutes of observation. The resulting pupil photographs were then analyzed and measured using special image processing software and compared. It was revealed that there were statistical differences in pupil dilation between solution I and solution II at 15 minutes (t=2.02; p=0.047), 20 minutes (t=2.23, p=0.029), and 25 minutes (t=2.041, p=0.045). Phenilefrine, tropicamide and diclofenac-natrium combination ...

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Glaucoma is the leading cause of irreversible blindness worldwide. Micropulse Transscleral Cyclophotocoagulation (MP-TSCPC) is a new method for treatment for refractory glaucoma with lesser complications than coventional TSCPC. This study aimed to evaluate the effectiveness and safety of MP-TSCPC (IRIDEX IQ810 Laser systems, CA) for refractory glaucoma treatment. This was a retrospective study using data obtained from the medical records of patients who underwent a MP-TSCPC procedure at Cicendo National Eye Hospital from July 2018 to September 2019. The outcomes measured were success rate (IOP decreased ≥30% from baseline with or without anti glaucoma medication at first month follow up) and post-operative complications. Fifty-seven eyes from 56 patients with a mean age of 57 years old underwent MP-TSCPC with 3 month follow up. The mean pre-operative intraocular pressure (IOP) dropped from 51.8 mmHg to 36.0 mmHg at 1 month follow up and 36.8 mmHg at the final follow up, representing an IOP decrease of 31% (1 month) and 28% (3 month). There was also a decrease of anti glaucoma medication usage from 2.51 to 2.16. The overall success rate at 1 month follow up was 49% and only 5% complication were found in this study. MP-TSCPC is safe and effective for lowering IOP and decreasing the need of anti glaucoma -medications in refractory glaucoma case. Further long-term evaluation and comparison to conventional TSCPC are still necessary.