Judul Jurnal : Descemet Membrane Detachment After

Phacoemulsification Surgery: Risk Factors and Success of

Air Bubble Tamponade
Latar Belakang & Tujuan : To evaluate the efficacy of air bubble (AB) tamponade for
Descemet membrane detachment (DMD) after clear corneal
incision phacoemulsification surgery and to evaluate the risk
factors for DMD.
Metodologi : This is a retrospective analysis of patients with DMD
managed with AB tamponade, within 42 postoperative days
(PODs), over a 4-year period. Data collected were as follows:
demographics, cataract density (Lens Opacities Classification
System III), visual acuity, AB technique, clinical outcome,
and total surgeries over the time period. Successful end points
were DM reattachment and corneal clarity. Risk factors were
assessed using a casecontrol study, with univariate and
multivariate logistic regression analyses (significance at P <
0.05).
Hasil : Incidence rate of DMD was 0.044% per year. Sixteen patients
(mean age of 76 years) had AB tamponade for DMD, with
corneal clarity restored in 14 cases (87.5%; n = 11 with 1 AB
procedure, n = 3 with 2 AB procedures). The main clear
corneal incision was the major site of DMD (n = 14, 87.5%).
Pre-AB visual acuity was 20/100 and at 1 month, 20/40.
Corneal clarity occurred by 30 days (range: 482 days) and
remained clear throughout the median follow-up of 12.9
months. Significant univariate factors were as follows: age
>65 years, nuclear sclerosis grade 4 (Lens Opacities
Classification System III), preexisting endothelial disease, and
first POD corneal edema. Multivariate logistic regression
analyses revealed endothelial disease (odds ratio = 18.66) and
first POD edema (odds ratio = 7.88) as significant
independent risk factors for DMD occurrence (P < 0.05).
Kesimpulan : AB tamponade for DMD effectively restored corneal clarity in
87.5% of cases (14 of 16 eyes). Significant risk factors
included endothelial disease and first POD corneal edema.
Rangkuman dan Hasil : This research is made to evaluate the efficacy of air buble
Pembelajaran tamponade for Descemet membrane detachment after clear
corneal incision phacoemulsification surgery and to evaluate
the risk factor
Results of this research shows that air bubble tamponade for
DMD effectively restored corneal clarity. Multivariate logistic
regression analyses revealed endothelial disease and first POD
edema as significant inependent risk factors for DMD
occurrence.
Judul Jurnal :
Bacterial contamination of the anterior chamber during
phacoemulsification cataract surgery
Latar Belakang & Tujuan : To determine the incidence of bacterial contamination of the
anterior chamber after phacoemulsification cataract surgery
with intraocular lens (IOL) implantation.

Metodologi : Ninety-eight consecutive eyes of 96 patients having

phacoemulsification cataract surgery with IOL implantation
were included in this prospective study. Two intraoperative
anterior chamber aspirates were obtained from each patient, 1
taken at the start and the other at the conclusion of surgery. In
addition, preoperative and postoperative conjunctival swabs
were acquired. The 4 specimens were cultured using direct
culturing techniques under aerobic and anaerobic conditions
for 14 days. No preoperative antibiotics were used.
Hasil : The incidence of intraoperative anterior chamber
contamination was 0% (95% confidence interval, 0%-3.7%)
as all intraoperative anterior chamber samples proved culture
negative. Sixty-five percent of the preoperative conjunctival
swabs were positive for growth, with corynebacteria,
coagulase-negative staphylococci, and Propionibacterium
acnes being the most frequently cultured organisms. Sixteen
percent of the postoperative conjunctival swabs were positive
for growth, with corynebacteria and coagulase-negative
staphylococci being the most common bacteria. One patient
developed culture-positive postoperative endophthalmitis;
using pulsed-field gel electrophoresis for further typing, the
implicated Staphylococcus epidermidis was indistinguishable
from that isolated from the patients preoperative conjunctival
swab.
Kesimpulan : The bacterial contamination rate of the anterior chamber after
phacoemulsification and IOL implantation was extremely low.
Additional findings support the conjunctiva as being a
primary source of bacteria causing postoperative
endophthalmitis as well as the ability of povidone-iodine to
reduce the conjunctival bacterial load.
Rangkuman dan Hasil : This research shows that bacterial contamination rate of the
Pembelajaran anterior chamber after pfacoemulsification and IOL
implantation was extremely low. Conjunctiva is the primary
source of bacteria causing postoperative endophtalmitis and
also as the ability of provodine-iodine to reduce the
conjunctival bacterial load
Judul Jurnal : Subjective difficulty of each stage of phacoemulsification
cataract surgery performed by basic surgical trainees
Latar Belakang & Tujuan : To measure the relative difficulty of each stage of
phacoemulsification surgery performed by basic surgical
trainees.
Metodologi : This prospective study comprised 100 consecutive cases of
phacoemulsification performed by 8 trainee surgeons over an
11-month period. The trainees completed a questionnaire at
the end of surgery, rating the degree of difficulty of 8
individual stages of phacoemulsification on a 5-point scale
from 1 (very easy) to 5 (very difficult).
Hasil : At the start of the study, trainees had spent a mean of 9.4
months training. The mean preoperative best corrected
decimal visual acuity was 20/70. The most difficult stages
were phacoemulsification and capsulorhexis with the highest
mean scores of 3.32 1.00 (SD) and 3.30 1.24, respectively
and the lowest completion rates of 66.7% and 74.4%,
respectively. The first 3 stages of peribulbar blockade (1.72
0.75), draping the surgical field (1.35 0.70) and corneal
incision (1.97 0.72) were easiest and had close to a 100%
completion rate. Hydrodissection, irrigation/aspiration, and
intraocular lens insertion had difficulty rates of 2.42 0.92,
2.80 1.10, and 2.58 1.08, respectively, and completion
rates of 92.3%, 78.4%, and 83.1%, respectively. Posterior
capsule tear occurred in 9%, including 4% with vitreous loss;
there was 1 case of zonular dehiscence.
Kesimpulan : Trainee surgeons found phacoemulsification and
capsulorhexis the most difficult stages of cataract surgery
early in the learning curve. More time can be dedicated to
mastering these steps in the wet lab.
Rangkuman dan Hasil : This research shows that the most difficult stages were
Pembelajaran phacoemulsification and capsulorhexis, this supported with
the lowest completion rate from both of this stages. It means
that in phacoemulsification, both of this stages need more
attention.
Judul Jurnal : Intracameral mydriatics in phacoemulsification cataract
surgery
Latar Belakang & Tujuan : To evaluate intracameral injection of mydriatics in
phacoemulsification cataract surgery and compare the results
with those of conventional topical mydriatics.

Metodologi : This prospective randomized double-blind study included 60

patients who were given topical (topical group) or
intracameral (intracameral group) mydriatics. The topical
mydriatics comprised 3 drops of cyclopentolate 1% and
phenylephrine 10% given 15 minutes apart and 150 L
intracameral lidocaine hydrochloride 1% (Xylocaine) and
the intracameral mydriatics, placebo eyedrops and 150 L
intracameral cyclopentolate 0.1%, phenylephrine 1.5%, and
Xylocaine 1%. The pupil size was recorded preoperatively,
throughout surgery, and 1 day and 1 month postoperatively.
Preoperative and postoperative corneal endothelial
morphology, corneal thickness, intraocular pressure, visual
acuity, aqueous cells and flare, phacoemulsification energy,
duration of surgery, pulse, blood pressure, and intraoperative
sensation of pain and glare were also recorded.
Hasil : With intracameral mydriatics, mydriasis reached 95% 3%
(SD) of its final value within 20 seconds. In the intracameral
group, the pupils were smaller than in the topical group (mean
6.7 1.0 mm versus 7.7 1.0 mm, P<.001) but did not
contract intraoperatively. The pupils in the topical group
tended to contract, and the difference between groups was
significant (P = .0020). The intracameral group reported less
glare during the procedure (P<.001). There was no difference
in endothelial cell loss, inflammatory reaction, postoperative
corneal swelling, or surgical performance between the groups.
Kesimpulan : Intracameral mydriatics were a rapid, effective, and safe
alternative to topical mydriatics in phacoemulsification. Their
use can simplify preoperative routines and in certain high-risk
groups, may reduce the risk for cardiovascular side effects.
Rangkuman dan Hasil : The results indicates that Intracameral mydriatics were a
Pembelajaran rapid, effective, and safe alternative to tropical mydriatics in
phacoemulsification. The usage of intracameral mydriatics is
faster than tropical mydriatic but the pupil size is smaller and
did not contract intraoperatively. There are no significant
difference in endothelial cell loss, inflammatory reaction,
postoperative corneal swelling, or surgical performcance
between the groups.
Judul Jurnal : Modern phacoemulsification compared with extracapsular
cataract surgery

Latar Belakang & Tujuan : To investigate whether modern phacoemulsification surgery

results in more damage to the corneal endothelium than
extracapsular cataract extraction (ECCE), and to examine
which preoperative, operative, and postoperative factors
influence the effect of cataract surgery on the endothelium.

Metodologi : Central corneal endothelial cell counts, coefficient of variation

of cell size, and hexagonality were assessed before surgery
and up to 1 year postoperatively.

Hasil : Four hundred thirty-three patients completed the trial. The

initial preoperative mean cell count for the entire sample was
2481 (standard error [SE]: 18.6), reduced at 1 year
postoperatively to 2239 (SE: 23.5). An average 10% reduction
in cell count was recorded by 1 year postoperatively. There
was no such change in hexagonality or in the coefficient of
variation. There was no significant difference in overall
percentage cell loss between the 2 treatment groups. Factors
associated with excessive cell loss (15% by 1 year) were a
hard cataract (odds ratio [OR]: 2.1, 95% confidence limits:
1.14.1; P = 0.036), age (OR: 1.04, P = 0.005), and capsule or
vitreous loss at surgery (OR: 2.38, P = 0.106).
Phacoemulsification carried a significantly higher risk (OR:
3.7, P = 0.045) of severe cell loss in the 45 patients with hard
cataracts relative to ECCE (52.6% vs. 23.1%; chi-square test,
P = 0.041), with both procedures achieving similar
postoperative visual acuity outcomes.

Kesimpulan : No significant difference in overall corneal endothelial cell

loss was found between these 2 operative techniques. The
increased risk of severe cell loss with phacoemulsification in
patients with hard cataracts suggests that phacoemulsification
may not be the optimal procedure in these cases, and that
ECCE should be preferred.

Rangkuman dan Hasil : The purpose of this research is to investigate whether modern
Pembelajaran phacoemulsification surgery results in more damage to the
corneal endothelium than extracapsular cataract extraction
(ECCE). The results indicates that there are no significant
difference in overall corneal endothlial cell loss was foound
between there 2 operative techniques.
Judul Jurnal :
ESCRS study of prophylaxis of postoperative
endophthalmitis after cataract surgery
Latar Belakang & Tujuan : To report results in the European Society of Cataract &
Refractive Surgeons (ESCRS) multicenter study of the
prophylaxis of endophthalmitis after cataract surgery.
Metodologi : This partially masked randomized placebo-controlled
multinational clinical study to evaluate prospectively the
prophylactic effect of intracameral cefuroxime injection
and/or perioperative levofloxacin eyedrops on the incidence
of endophthalmitis after phacoemulsification cataract surgery
began in September 2003 and was terminated early in January
2006. The study used random allocation of patients in a 2 2
factorial design.
Hasil : By the end of 2005, complete follow-up records had been
received for 13698 study patients. Such a clear beneficial
effect from the use of intracameral cefuroxime had been
observed that it was agreed it would be unethical to continue
the study and to wait for the completion of all follow-up
procedures before reporting this important result. If total
reported cases of endophthalmitis are considered, the
incidence rate observed in those treatment groups not
receiving cefuroxime prophylaxis (23 cases in 6862 patients)
was almost 5 times as high (odds ratio [OR], 4.59; 95%
confidence interval [CI], 1.74-12.08; P = .002) as that in the
groups receiving this treatment (5 cases in 6836 patients). If
only cases proved to be due to infection are considered, the
rate was more than 5 times as high (OR, 5.32; 95% CI, 1.55-
18.26; P = .008) in the treatment groups not receiving
cefuroxime. Although the use of perioperative levofloxacin
eyedrops as prophylaxis was also associated with a reduction
in the observed incidence rate of postoperative
endophthalmitis, this effect was smaller and was not
statistically significant, whether total reported cases or only
cases proven to be due to infection are used in calculating the
rates. As not all follow-up procedures are complete, it is
possible that further cases of endophthalmitis may be
reported; however, it is not expected that this will alter the
main conclusion. Nevertheless, it is anticipated that successful
completion of follow-up procedures in all patients will
increase the total number in the study to approximately 16
000.

Kesimpulan : Intracameral cefuroxime administered at the time of surgery

significantly reduced the risk for developing endophthalmitis
after cataract surgery.
Rangkuman dan Hasil : This research is made to analyze the results of ESCRS study
Pembelajaran of prophylaxis of postoperative endophthalmitis after cataract
surgery. It can be achieved by evaluating prospectively the
prophylactic effect of intracameral cefuroxime injection
and/or perioperative levofloxacin eyedrops on the incidence
of endophthalmitis after phacoemulsification cataract surgery.
The results indicates that intracameral cefuroxime
administered at the time of surgery significantly reduced the
risk for developing endophthalmitis.
Judul Jurnal :
Visual experience during phacoemulsification cataract
surgery under topical anaesthesia
Latar Belakang & Tujuan : Visual awareness during phacoemulsification cataract surgery
is an important determinant of patient satisfaction with any
anaesthetic technique. Topical anaesthesia could be associated
with significant visual awareness because it does not affect
optic nerve function.
Metodologi : The visual experience during phacoemulsification cataract
surgery under topical anaesthesia (without sedation) was
assessed for 106 consecutive unselected patients. Patients
were interviewed immediately after surgery using a
standardised questionnaire that explored specific aspects of
their visual experience.
Hasil : Four patients were excluded because they had poor
recollection of their visual experience. The visual awareness
of the remaining 102 patients comprised operating microscope
light (99), colours (73), flashes of light (7), vague movements
(19), surgical instruments or other objects (12), change in
light brightness during surgery (49), change in colours during
surgery (30), and transient visual alteration during corneal
irrigation (25). No patient found their visual experience
during surgery unpleasant, though the operating microscope
light was uncomfortably bright for two patients. Six patients
lost light perception for a short interval during surgery. There
was no association between the various visual phenomena
reported and patients' age, sex, preoperative visual acuity,
cataract morphology, coexisting ocular pathology, or previous
experience of cataract surgery under local anaesthesia
(p>0.05).
Kesimpulan : Patients experience a wide variety of visual sensations during
phacoemulsification cataract surgery under topical
anaesthesia. Topical anaesthesia does not, however, appear to
result in greater visual awareness than regional anaesthesia.
Preoperative patient counselling should include information
about the visual experience during surgery.
Rangkuman dan Hasil : This reseach has a puprpose to investigate the effect of topical
Pembelajaran anaesthesia in visual awareness of patients. From the results
can be concluded that patients experience a wide variety of
visual sensations during phacoemulsification cataract surgery
under topical anaesthesia, but does not result in greater visual
awareness than regional anaesthesia.
Judul Jurnal :
Visual perception during phacoemulsification cataract
surgery under topical and regional anaesthesia
Latar Belakang & Tujuan : To compare the subjective visual experiences of patients
during phacoemulsification and intraocular lens (IOL)
implantation using regional and topical anaesthesia.
Metodologi : The study cohort consisted of 247 patients without pre-
existing ocular pathology who underwent routine
phacoemulsification and IOL implantation. The mean age of
the subjects was 75.4 9.4 years and 34.5% of them had a
history of cataract surgery. Three different methods of local
anaesthesia were used: 66 (26.7%) of the patients were given
topical anaesthesia (TA); 74 (30.0%) were given sub-Tenon's
anaesthesia (SA), and 107(43.3%) were given peribulbar
anaesthesia (PA). The patients were interviewed immediately
after surgery by theatre staff using a standardized
questionnaire that investigated their intraoperative visual
experiences.
Hasil : There was no significant difference between the three
methods of anaesthesia regarding light perception during the
surgery. However, patients undergoing surgery under TA
experienced brighter light intensity levels (78.3%) than those
given SA (50.0%) and PA (55.7%) (p = 0.02). A total of
69.6% of subjects who received TA reported visual perception
of colours during surgery, as opposed to 56.8% of SA
recipients and 49.0% of PA recipients (p = 0.02). In addition,
patients under TA were more aware of surgical instruments
(26.1%) than those under SA (10.8%) and PA (15.9%) (p =
0.08). The vast majority of patients in all three groups found
the visual experience to be non-frightening. There were no
associations between intraoperative visual impression and age
or sex. Although not statistically significant (p = 0.06), prior
cataract surgery appeared to alleviate some of the anxiety
associated with the visual experience.
Kesimpulan : Patients undergoing regional and topical anaesthesia
experience a wide variety of visual sensations during surgery.
The differences in visual impressions between the groups may
reflect the varying degrees of optic nerve blockade that result
from the different anaesthetics.
Rangkuman dan Hasil : From the results of this research several things can be
Pembelajaran concluded such as there was no significant difference between
methods of anaesthesia regarding light perception, patients
under topical anaesthesia experienced brighter and more
colour during surgery, there were no associations between
intraoperative visual impression and age or sex. Patients
undergoing regional and topical anaesthesia experience a wide
variety of visual sensations during surgery. The differences in
visual impressions between the groups may reflect the varying
degrees of optic nerve blockade that result from the different
anaesthetics.
Judul Jurnal : Induced endothelial cell loss in phacoemulsification using
topical anesthesia plus intracameral lidocaine
Latar Belakang & Tujuan : To determine whether lidocaine 1% injected into the anterior
chamber during phacoemulsification damaged the corneal
endothelium.
Metodologi : In 19 eyes of 19 patients, small incision phacoemulsification
and foldable lens (AcrySof MA60BM) implantation was
performed using topical anesthesia supplemented by lidocaine
1% (0.3 mL) in the anterior chamber. All cases were operated
by the same surgeon. Specular microscopy was performed
before surgery and 1 and 3 months postoperatively.

Hasil : Mean endothelial cell loss was 5.41% 8.50 (SD) at 1 month
and 5.93 8.50% at 3 months.

Kesimpulan : The endothelial damage was similar to that described by other

authors, suggesting that phacoemulsification surgery can be
performed successfully using topical anesthesia supplemented
by lidocaine 1% in the anterior chamber.

Rangkuman dan Hasil : The purpose of this research is to determine whether lidocaine
Pembelajaran 1% injected into the anterior chamber during
phacoemulsification damaged the corneal endothelium. The
results shows that phacoemulsification surgery can be
performed successfully using topical anesthesia supplemented
by lidocaine 1% in the anterior chamber.
Judul Jurnal : Corneal endothelial damage after cataract surgery:
Microincision versus standard technique

Latar Belakang & Tujuan : To compare corneal endothelial changes after

phacoemulsification performed with a standard technique
versus a bimanual microincision cataract surgery (MICS)
technique.

Metodologi : Eighty patients scheduled for routine cataract surgery were

randomized into 2 groups; 40 eyes had standard stop-and-
chop phacoemulsification (standard group) and 40 eyes had
stop-and-chop phacoemulsification with microincision
surgery (MICS group). Central corneal endothelial cell
counts, coefficient of variation in cell size, hexagonality, and
pachymetry were assessed preoperatively and 1 and 3 months
postoperatively.

Hasil : The mean preoperative cell count in the entire sample was
2245 cells/mm2 37 (SE). The mean decreased by 102 cells
at 1 month (95% confidence interval [CI], 133 to 71;
P<.001) and by 144 cells at 3 months (95% CI, 187 to 102;
P<.001). The difference between the standard group and the
MICS group was 25 cells at baseline (95% CI, 169 to 120
cells; P = .739), 19 cells at 1 month (95% CI, 163 to 126; P =
.799), and 19 cells at 3 months (95% CI, 164 to 125; P = .
793). There were no changes in the coefficient of variation or
morphology in the overall sample, and the pattern of change
did not differ between the 2 groups. Corneal thickness
increased by 10.2 m in the overall sample (95% CI, +4.5 to
+16.0; P<.001) and approached baseline values by 3 months
with an increase of 3.4 m (95% CI, 4.1 to 10.8; P = .372).
There was no difference in corneal thickness between the
groups.

Kesimpulan : No significant differences in corneal endothelial cell loss or

endothelial morphology were found between MICS and
standard incision techniques.

Rangkuman dan Hasil : This research is made to compare corneal endothelial changes
Pembelajaran after phacoemulsification performed with a standard
technique versus a bimanual microincision cataract surgery
(MICS) technique. From the results can be concluded that
there are no significant differences in corneal endothelial cell
loss or endothelial morphology were found between MICS
 and standard incision techniques.

Judul Jurnal : Occurrence and progression of diabetic retinopathy after

phacoemulsification cataract surgery
Latar Belakang & Tujuan : To evaluate the risk factors associated with the occurrence and
progression of diabetic retinopathy (DR) after
phacoemulsification cataract surgery.
Metodologi : The medical charts of 52 eyes of 48 consecutive patients who
had phacoemulsification were retrospectively reviewed. The
occurrence of DR (new development of any DR) and
progression (DR requiring laser treatment) were correlated
with patients' age, sex, duration of diabetes, control of
diabetes, hypertension, ischemic heart disease, and surgical
technique. Exclusion criteria were significant ocular
conditions and a follow-up shorter than 6 months.
Hasil : The occurrence of DR was associated with male sex, and
among males, with the duration of the disease. An analysis
including all patients showed that postoperative progression
of preexisting DR was not associated with any factor except
poor blood sugar control. Neither the occurrence nor
progression of DR was associated with reduced visual acuity
Kesimpulan : The occurrence and progression of DR after
phacoemulsification were associated with different factors.
Poor systemic control of diabetes increases the risk.
Rangkuman dan Hasil : This research is made by review 48 consecutive patients who
Pembelajaran had phacoemulsification retrospectively. The occurrence and
progression of diabetic retinopathy and progression were
correlated with patients age, sex, duration of diabetes, control
of diabetes, hypertension, ischemic heart disease, and surgical
technique.
Judul Jurnal : Posterior capsule opacification after phacoemulsification:
foldable acrylic versus poly(methyl methacrylate)
intraocular lenses
Latar Belakang & Tujuan : To study the effects of foldable acrylic and poly(methyl
methacrylate) (PMMA) intraocular lens (IOL) implantation
on posterior capsule opacification (PCO).

Metodologi : This consecutive series comprised 157 eyes having

phacoemulsification with implantation of a foldable acrylic
IOL with rectangular optic edges and a 5.5 mm optic
(AcrySof) (n = 80 eyes) or a PMMA IOL with rounded optic
edges and 5.5 mm optic (n = 77). Evaluated were incidence,
location, and degree of PCO. Mean postoperative follow-up
was 17.8 months 1.7 (SD) (range 16 to 22 months).

Hasil : Posterior capsule opacification occurred in 8.7% of eyes in

the foldable acrylic IOL group and in 24.7% of eyes in the
PMMA IOL group. The difference between the 2 groups was
statistically significant (P < .01). Centrally located PCO was
significantly lower in the acrylic group (P < .01). There were
3 eyes with severe PCO in the PMMA group and none in the
acrylic group. Anterior capsule contraction and fibrosis were
present in 4 eyes in the PMMA group but none in the acrylic
group. Soemmerings ring cataract formation was detected in
3 eyes, all with the AcrySof IOL.

Kesimpulan : In addition to its optic material and rectangular optic edges,

the AcrySof IOL provides additional advantages in lowering
the incidence of PCO compared with rounded-edge PMMA
IOLs.

Rangkuman dan Hasil : In order to investigate the effects of posterior capsule

Pembelajaran opacification after phacoemulsification with foldable acrylic
and poly intraocular lenses. From this research its known that
AcrySof IOL provides advantages in lowering the incidence
of PCO compared with rounded-edge PMMA IOLs.
Judul Jurnal : Trypan blue as an adjunct for safe phacoemulsification in
eyes with white cataract

Latar Belakang & Tujuan : To assess the feasibility, risks, and postoperative outcomes of
phacoemulsification with posterior chamber intraocular lens
(PC IOL) implantation in cases of white cataract with the use
of trypan blue as an adjunct for performing continuous
curvilinear capsulorhexis (CCC) in the absence of a red
reflex.

Metodologi : This prospective study comprised 52 eyes of 52 patients with

white cataract that had phacoemulsification through a clear
corneal temporal incision with PC IOL implantation. In all the
cases, trypan blue was used under air to stain the anterior lens
capsule and the karate-chop technique was used to emulsify
the nucleus. The mean follow-up was 192.2 days.

Hasil : Trypan blue adequately stained the anterior lens capsule in all
cases. The CCC was completed uneventfully in 96.15% eyes;
3.85% of cases had to be converted to a conventional
extraction technique because of the loss of the CCC. The
mean phacoemulsification time was 2.2 minutes. Intraocular
complications included incomplete capsulorhexis (3.85%) and
pupillary miosis (3.80%). Postoperatively, 3 eyes (5.77%) had
corneal edema (striate keratopathy) and 1 eye (1.9%) had
fibrin in the anterior chamber. Five eyes (9.61%) had more
than 2+ cells and flare at 2 weeks. All responded well to
intensive topical and subconjunctival steroids. There were no
cases of endophthalmitis. The mean central endothelial cell
loss, measured in 37 eyes, was 8.5%. Of the 4 eyes (7.69%)
that had increased intraocular pressure (IOP) postoperatively,
all responded well to medications and the IOP was normal by
the second postoperative week. Fifty eyes (96.16%) had a
final best corrected visual acuity of 20/30 or better. In 2 cases,
the final visual acuity was worse than 20/200 because of
preexisting posterior segment pathology.

Kesimpulan : Phacoemulsification using trypan blue was safe and effective

in managing white cataract and had a high success rate.

Rangkuman dan Hasil : This research is made to assess the feasibility, risks, and
Pembelajaran postoperative outcomes of phacoemulsification with posterior
chamber intraocular lens (PC IOL) implantation in cases of
white cataract with the use of trypan blue as an adjunct for
performing continuous curvilinear capsulorhexis (CCC) in the
absence of a red reflex. Trypan blue adequately stained the
anterior lens capsule in all cases. The CCC was completed
uneventfully in 96.15% eyes; 3.85% of cases had to be
converted to a conventional extraction technique because of
the loss of the CCC. From this results, it can be concluded
that phacoemulsification using trypan blue was safe and
effective in managing white cataract and had a high success
rate.
Judul Jurnal : Medical control of intraocular pressure after
phacoemulsification

Latar Belakang & Tujuan : To compare the effectiveness of oral acetazolamide, topical
brinzolamide 1%, and no ocular hypotensive medication after
phacoemulsification.

Metodologi : This prospective randomized double-blind study comprised

60 eyes of 52 patients having phacoemulsification under
topical anesthesia. There were no intraoperative
complications. Eyes were randomized to receive oral
acetazolamide 500 mg 1 hour preoperatively followed by 250
mg acetazolamide every 6 hours, 1 drop of brinzolamide 1%
every 12 hours starting immediately after speculum removal,
or no ocular hypotensive medication. Intraocular pressure
(IOP) was measured using a Perkins tonometer preoperatively
and 4 to 6 hours and 18 to 24 hours postoperatively.

Hasil : The preoperative IOP was not significantly different between

the 3 groups. Four to 6 hours postoperatively, the
acetazolamide group (P = .002) and brinzolamide group (P = .
001) had significantly lower IOP than the control group. The
same trend was observed at 18 to 24 hours in the brinzolamide
group (P = .001) but not the acetazolamide group (P = .018).
The IOP levels were not significantly different between the
acetazolamide group and brinzolamide group at any
postoperative time point. No eye receiving medication and 2
eyes (10%) in the control group had an IOP of 30 mm Hg or
higher 4 to 6 hours postoperatively. Compared with
preoperatively, an IOP increase of more than 5 mm Hg was
seen at 4 to 6 hours in 3 eyes (15%), 2 eyes (10%), and 14
eyes (70%) in the acetazolamide, brinzolamide, and control
group, respectively.

Kesimpulan : Brinzolamide was as effective as acetazolamide in preventing

IOP elevation 4 to 6 hours after phacoemulsification and more
effective than acetazolamide at 18 to 24 hours.

Rangkuman dan Hasil : The main purpose of this research is to compare the
Pembelajaran effectiveness of oral acetazolamide, topical brinzolamide 1%,
and no ocular hypotensive medication after
phacoemulsification. The preoperative IOP was not
significantly different between the 3 groups. Brinzolamide
was as effective as acetazolamide in preventing IOP elevation
4 to 6 hours after phacoemulsification and more effective than
 acetazolamide at 18 to 24 hours.
Judul Jurnal : Corneal endothelial changes after divide and conquer
versus chip and flip phacoemulsification

Latar Belakang & Tujuan : To evaluate changes in central corneal endothelial cells and
corneal thickness after divide and conquer
phacoemulsification and chip and flip phacoemulsification.
Metodologi : Forty-four eyes were randomly assigned to one of two groups
to have divide and conquer (D/C Group) or chip and flip (C/F
Group) phacoemulsification with implantation of a posterior
chamber, foldable, silicone intraocular lens performed by one
surgeon. Of these, 41 eyes of 37 patients (22 D/C Group, 19
C/F Group) met the inclusion criteria. All surgeries were
uneventful. A complete eye examination including specular
microscopy and pachymetry was performed preoperatively
and 1 week and 1 and 3 months postoperatively.
Hasil : There were no significant between-group differences in any of
the following means: sex; age; time at 70% phaco power; total
phacoemulsification time. No correlation was found between
ultrasound time and increased corneal thickness except for a
significant increase in percentage of hexagonal cells in the
C/F Group at 1 month. The only statistically significant
between-group differences were greater endothelial cell loss
in the C/F Group at 1 month and the percentage change in
hexagonal cells at 1 week (1.1 % increase, D/C Group; 10.7%
decrease, C/F Group).
Kesimpulan : The divide and conquer technique led to less endothelial loss
and hexagonal cell change than the chip and flip technique,
although at 3 months the differences were not significant.
Rangkuman dan Hasil : From the results gathered in this researched it can be
Pembelajaran concluded that there were no significant between-group
differences in any of the following means: sex; age; time at
70% phaco power; total phacoemulsification time. No
correlation was found between ultrasound time and increased
corneal thickness except for a significant increase in
percentage of hexagonal cells in the C/F Group at 1 month.
The divide and conquer technique led to less endothelial loss
and hexagonal cell change than the chip and flip technique,
although at 3 months the differences were not significant.