PPT Case Subdivisi Refraksi Fitriat.pptx

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1. ASTIGMATISM POST PHACOEMULSIFICATION Fitria Rizki* CONSULTANT dr.Ani , Sp.M (K), Subsp.ROV dr. Eva Kumalasari , Sp.M Ophthalmology D epartmen t Medical F aculty of S riwijaya U niversity Dr. M oh . Hoesin H ospital P alembang 2024 Case Report

2. Refractive error after cataract surgery typically manifests with blurred vision at distances INTRODUCTION First step in management of refractive error after cataract surgery are determining patient expectations . Corneal decompensation or irregularity due to surgery , eye drops , or trauma may result in pathology that was not present preoperatively . Keratometry, Corneal Topography and Corneal Tomography are ways to measure and treat astigmatism at the time of cataract surgery

3. AIM To discuss a case of surgical management of Phacoemulsification Cataract Surgery that can caused an Astigmatism .

4. CASE REPORT

5. WOMEN 72 YEARS History of Illness Complaint : Blurred vision of the both eyes IDENTITY Since 2 year ago , the patient complained of a blurred vision of the both eyes . Initially the blurred vision was felt to get worsening over time. Since 2 months ago after cataract surgery , There are complaints of blurred vision.

6. • History of trauma • History of eyelid deformity at birth. • History of allergies. • History of frequent eyelid swelling or inflammation. • Family history of the same disease. Illness History in the past : History Illness There is no history of systemic diseases such as diabetes mellitus. DENIED

7. General appearance Compos mentis Blood Pressure 120/80 mmHG Heart rate 80 times per minute Respiratory rate 20 time per minute Temperature 36.5° C REVIEW OF SYSTEMS

8. PATIENTS PHOTOS

9. Ophthalmological status : Visual Acuity 6/60 ph (6/12) 6/45 ph (6/9) IOP 11.4 mmHg 14.2 mmHg Ocular Alignment Orthophoria Ocular Movement

10. Ophthalmological status : Right Eye Left Eye Palpebra Normal Normal Conjunctiva Normal Normal Cornea Clear Clear Anterior Chamber Normal Normal Iris Good Good Pupil Round, central , light reflex (+), Ø 3 mm Round, central , light reflex (+), Ø 3 mm Lens IOL (+) , Central IOL (+) , Central

11. Autoreftractometry

12. POSTERIOR SEGMENT Right Eye Left Eye RFO D (+) RFO S (+) Papil Round, delineated margin, normal color, c/d: 0.6, a/v: 2/3, Nasalization(+), Bayyonet Sign (-) Round, delineated margin, normal color, c/d: 0.3, a/v: 2/3 Round, delineated margin, normal color, c/d: 0.3, a/v: 2/3 Macula Fovea reflex (+) Fovea reflex (+) Fovea reflex (+) Retina Good vascular contour, tigroid appearance ( - ) Good vascular contour Good vascular contour

13. Laboratory Result ITEM RESULT NORMAL VALUE UNIT Hemoglobin 1 4.6 1 1 .4 -1 5 . 00 g/dl Er y tros y t es 4 . 73 4. 0- 5 . 7 10 3 /mm 2 Leukos y t es 6.6 4.73-10.89 10 3 /mm 2 Hematokr it 42 35-45 % Platelets 321 1 89 - 43 6 10 3 /µL Blood Glucose 129 < 200 mg/dL ITEM RESULT NORMAL VALUE UNIT Bleeding Time 1 1-3 Menit Clothing Time 4’30” 9-15 Menit Anti HIV Non Reaktif Non Reaktif U/L HbsAg Non Reaktif Non Reaktif U/L

14. Biometri , Keratometri , IOL calculation

15. Biometri , Keratometri , IOL calculation

16. USG Palpebra

17. Astigmatis m Post Phacoemulsification ODS Working Diagnosis

18. Consultation, Information, Education Refractive Correction Management

19. Prognosis Quo ad Vitam Quo ad Functionam Quo ad Sanationam Bonam Dubia ad Bonam Dubia ad Bonam

20. DISCUSSION

21. Discussion A 72 years old female patient with Blurred Vision while looking at distant object Astigmatism Post Phacoemulsification ODS Right Eye Left Eye Correction S-1.00 C-1.00 Ax 90  6/7.5 C-1.50 X 90  6/7.5 Right Eye Left Eye Pre - Operation S+0.50 C-2.50 X 85

22. CONCLUSION

23. There are several techniques available for addressing corneal astigmatism in the face of cataracts . As outlined above , each has its own set of advantages and limitations . The decision of which one of these techniques to use will of course dependend on the surgeon's comfort with each technique and the patient's expectations .. Keep in mind that as patient's expectations increase , there may come a time when these consumers ask for spectacle independence after cataract surgery .

24. THANKS