Perbedaan kadar malondialdehid pada lensa katarak komplikata dengan dan tanpa pemberian tetes mata natrium diklofenak 0,1 sebelum operasi

WIDOWATI, Wiwik, Prof.dr. Suhardjo, SU.,SpM(K)

2004 | Tesis | PPDSI Ilmu Penyakit Mata

Latar belakang: Katarak merupakan penyebab kebutaan utama di dunia dan Indonesia. Perubahan lokal dan sistemik seperti stres oksidasi, usia, paparan matahari, agen kimia dan katarak osmotik dapat menyebabkan perubahan pada lensa. Katarak komplikata adalah katarak yang disebabkan oleh penyakit lokal pada mata terutama penyakit inflamasi, atau keadaan degeneratif seperti ablasi retina lama, retinitis pigmentosa dan glaukoma kronis. Terdapat peningkatan kadar malondialdehid (MDA), suatu substansi yang diproduksi melalui proses peroksidasi lipid dan berperan dalam kataraktogenesis, pada katarak komplikata. Pemberian agen antiinflamasi akan menurunkan proses inflamasi sehingga menurunkan pembentukan prostaglandin dan pelepasan radikal bebas. Tujuan: Tujuan penelitian ini adalah untuk menentukan kadar malondialdehid lensa katarak komplikata pasien yang mendapat tetes mata Natrium Diklofenak 0,1% 3 kali sehari selama 2 minggu sebelum operasi. Bahan dan Cara: Suatu penelitian potong lintang terhadap pasien katarak komplikata yang mengalami operasi ekstraksi katarak ekstrakapsular di RS Dr. Sardjito, RS Mata Dr. Yap dan katarak massal di Yogyakarta dan sekitarnya, dari bulan November 2002 hingga November 2003. Subyek dibagi dalam 2 kelompok secara berurutan. Dua puluh pasien mendapat tetes mata Natrium Dikolfenak 0,1% 3 kali sehari selama 2 minggu sebelum dilakukan operasi, 20 pasien lainnya tidak mendapat tetes mata sebelum operasi. Setelah dilakukan operasi, lensa dibawa ke Laboratorium Biokimia untuk diperiksa kadar MDA. Perbedaan kadar MDA diantara 2 kelompok dianalisa secara statistik dengan student t test. Hasil: Rerata kadar MDA lensa katarak komplikata kelompok Natrium Diklofenak (4,386 + 2,625 nmol/g) berbeda secara bermakna dengan rerata kadar MDA lensa kelompok Tanpa Natrium Diklofenak (6,728 + 3,422 nmol/g) , p=0,020. Kesimpulan: Kadar MDA lensa katarak komplikata setelah pemberian tetes mata Natrium Diklofenak secara bermakna lebih rendah daripada kelompok Tanpa Natrium Diklofenak.

Background: Cataract is the leading cause of blindness in the world and Indonesia. Local and systemic changes can lead to the alteration of lens such as oxydative stress, age, radiating exposure, chemical agent and osmotic cataract. Complicated cataract is cataract caused by local disease of the eye, especially inflammatorry disease, or degenerative condition such as prolonged retinal detachment, retinitis pigmentosa, and chronic glaucoma.There is an increasing of Malondialdehyde (MDA) level in complicated cataract, a substance produced by lipid peroxidation and capable as cataractogenesis. Administration of anti inflammatorry agent will reduce the inflammation so that decrease the forming of prostaglandin and free radical releasing. Objective: To determine the level of malondialdehyde of lens in Complicated Cataract patient having instillation of Diclofenac Sodium 0,1% eye drop, 3 times daily, 2 weeks before undergoing surgery. Material and Method: A cross sectional study of Complicated Cataract patient who underwent extracapsular cataract extraction, conducted at Dr Sardjito General hospital, Dr. Yap Eye Hospital and mass cataract surgery in Yogyakarta and surrounding area, from November 2002 until November 2003. Subject were consecutively recruited and grouped into two groups. Twenty patients were given Diclofenac Sodium 0,1% eye drop 3 times daily as long as two weeks before lens extraction, and 20 patient who received no treatment as control. At the day of surgery performed, the lens was taken to measure the level of MDA at Laboratorium of Biochemistry. The difference of MDA level between two groups were statistically analyzed by student t test. Results: The mean of MDA level in Diclofenac Sodium Group was 4,386 + 2,625 nmol/g, while Without Diclofenac Sodium group was 6,728 + 3,422 nmol/g. This difference was statistically significant with p = 0,020. Conclusion: The mean of MDA level in Diclofenac Sodium Group was lower than Without Diclofenac Sodium group.

Kata Kunci : Katarak Komplikata,Natrium Diklofenak 0,1 Persen,Operasi, malondialdehyde level-cataractogenesis-complicated cataract-diclofenac sodium