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Maharani, Prahasta A, Gustianty E

TRABECULECTOMY IN SECONDARY GLAUCOMA AFTER PARS PLANA VITRECTOMY WITH INTRAVITREAL SILICONE OIL

ABSTRACT

Background: to determine the results of trabeculectomy in secondary glaucoma after pars plana vitrectomy and intravitreal silicone oil

Methods: the records of 7 patients with secondary glaucoma after pars plana vitrectomy and intravitreal silicone oil who undergone silicone oil removal and trabeculectomy with/out mitomycin-C in Cicendo Eye Hospital from January 2009 to February 2011 intraocular pressure before surgery, first hour, first week, first month and second month after surgery were recorded and analized

Results: Four (57.14%) of 7 patients were above 45 years old, average age was 46.14 years old (range 29 63). Coincidentally, all of them were man. Five (71.43%) eyes were aphakic. Average onset of glaucoma was 78 days (range 2 270). Mean IOP first day after surgery was 7.86 mmHg, first week after surgery was 25.86 mmHg, first month after surgery was 17.5 mmHg and second month after surgery was 16.33 mmHg. One subjects was success, 3 subjects were qualified success and 2 subjects were failed. Six eyes (85.71%) got silicone oil in anterior chamber, four of them were emulsified silicone oil, 57.1% were success and 28.4% were failure (p=0,49). Average intraocular pressure prior surgery was 55.4±15.35 in success group and 46.0±22.6 in failed group (p=0,507). Five eyes underwent trabeculectomy+MMC, four of them (57.1%) were success (p=0,427) Conclusion: age, aphakic, silicone oil in anterior chamber, emulsified silicone oil and the use of antifibrotik agent were factors contributing success rate of trabeculectomy in secondary glaucoma after pars plana vitrectomy and intravitreal silicone oil but there were no significantly related.

Keywords: Trabeuletomy, secondary glaucoma, silicone oil, intraocular pressure

ABSTRAK

Latar belakang: untuk mengetahui keberhasilan operasi trabekulektomi pada glaukoma sekunder pasca vitrektomi pars plana dengan silicone oil intravitreal

Metode: data dari 7 pasien dengan glaukoma sekunder pasca vitrektomi pars plana dengan silicone oil intravitreal yang telah dilakukan pengambilan silicone oil dan trabekulektomi dengan atau tanpa mitomicin C di rumah sakit Cicendo dari Januari 2009 sampai dengan Februari 2011. Tekanan intraokuler (TIO) sebelum operasi, 1 hari, 1minggu, 1 bulan dan 2 bulan pasca operasi dicatat dan dianalisis. Hasil: empat (57,14%) dari 7 pasien berusia diatas 45 tahun, dengan rata-rata usia 46,14 tahun (rentang usia 29–63). Semua pasien laki- laki. Lima (71,43%) subjek afakia. Onset glaucoma sekunder rata-rata 78 hari (rentang waktu 2–270). rata rata TIO 1 hari pasca bedah

7,86 mmHg , 1 minggu pasca bedah 25,83 mmHg , 1 bulan pasca bedah 17,50 mmHg, 2 bulan pasca bedah 16,33 mmHg. Satu pasien mengalami keberhasilan tanpa pemberian antiglaukoma topikal pasca bedah, 3 pasien mengalami keberhasilan namun dengan penambahan antiglaukoma topikal pasca bedah dan 2 pasien mengalami kegagalan dan 1 penderita tidak diperoleh data TIO setelah 1 hari pasca bedah. Enam subjek (85,71%) terdapat silicone oil di bilik mata depan, empat diantaranya telah terjadi emulsifikasi,

57,1% mengalami keberhasilan penurunan TIO dan 28,4% mengalami kegagalan. Lima subjek dilakukan trbekulektomi dengan MMC

dan empat (57,1%) diantaranya mengalami keberhasilan (p=0,427).

Simpulan: usia, status lensa, adanya silicone oil di bilik mata depan dan penggunaan antifibrotik tidak mempengaruhi keberhasilan operasi trabekulektomi pada glaukoma sekunder pasca vitrektomi pars plana dengan silicone oil intravitreal

Kata kunci: Trabekulektomi, glaucoma sekunder, silicone oli, tekanan intraokuler

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