Perbandingan ekspresi TGF ? Konjungtiva setelah pemberian Mitomycin C subkonjungtiva dan Triamsinolon asetonide subkonjungtiva pada Pterigium Primer Progresif

NUGRAHANI, Ida, dr. Agus Supartoto, SpM(K)

2006 | Tesis | PPDS I Penyakit Mata

Latar belakang Pterigium masih menjadi masalah karena risiko kekambuhan pasca bedah yang tinggi dan sukar diatasi. Beberapa penelitian membuktikan adanya keterlibatan TGF ß pada patogenesis maupun rekurensi pterigium. Angka kekambuhan pterigium lebih tinggi pada ekspresi TGF ß tinggi. Mitomycin C adalah agent antiproliferatif yang poten, yang bekerja dengan menghambat sintesis dan fungsi DNA. Tujuan Membandingkan ekspresi TGF ß konjungtiva setelah pemberian Mitomycin C subkonjungtiva dan Triamsinolon asetonid subkonjungtiva pada pterigium primer progresif. Bahan dan cara Penelitian eksperimental, dilakukan pada 60 pasien pterigium primer progresif, secara acak dibagi menjadi 2 kelompok perlakuan. Mitomyc in C 0.1 ml (0.15 mg/ml) dan Triamsinolon asetonide 0.1 ml (40 mg/ml) subkonjungtiva dilakukan pada masing-masing 30 mata, 1 minggu pre operatif. Penelitian dilakukan di RS dr. Sardjito dan RS Mata dr. YAP pada bulan Juni 2004- Nopember 2005. Seluruh subyek dilakukan ekstirpasi pterigium (Mc Reynolds). Jaringan konjungtiva hasil operasi dilakukan pemeriksaan ekspresi TGF ß dengan tehnik imunohistokimia monoklonal antibodi. Perbedaan ekspresi TGF ß konjungtiva antara 2 kelompok dianalisa dengan uji statistik t test. Hasil Subyek penelitian ini berusia 22-49 tahun, jenis kelamin laki-laki dan perempuan tersebar merata. Ekspresi TGF ß konjungtiva lebih rendah pada kelompok Mitomycin C subkonjungtiva (12,02 ± 3,91) dibandingkan dengan kelompok Triamsinolon asetonide subkonjungtiva (16,03 ± 8,84) dengan nilai p = 0,029. Simpulan Ekspresi TGF ß konjungtiva pasien pterigium primer progresif yang diinjeksi mitomycin C subkonjungtiva lebih rendah secara bermakna dibanding yang diinjeksi triamsinolon asetonid subkonjungtiva.

Background Pterygium remains a difficult problem because the risk of recurrence after extirpation still high and difficult to treat. Some studies proved any involvement of TGF ß on pathogenesis as well as the recurrence process of pterygium. Recurrence rate was higher in the high TGF ß expression. Mitomycin C is a potent antiproliferatif agent, it works as an anti mitotic cell which stop the DNA synthesis & function. Objective To compare conjunctiva TGF ß expression of progressive primary pteygium that has been applied with Mitomycin C and Triamsinolon asetonid subconjunctivally. Material and Method Experimental study was performed in 60 patients with progressive primary pteygium. The study was conducted in Dr. Sardjito general hospital and Dr. YAP Eye Hospital between June 2004 and November 2005. The patient divided into 2 groups randomly. Thirty patients received 0,1 ml of 0,15 mg/ml Mitomycin C subkonjungtivally and 30 patients received 0,1 ml of 40 mg/ml Triamsinolon asetonide subkonjungtivally, 1 week before operation. Mc Reynolds method was conducted to extirpate the pterygium. TGF ß expression was evaluated by antibody monoklonal immunohistochemistry method by count the number of positive cell every 100 cells which were examined. The differences of TGF ß expression among the 2 groups were analyzed by t test. Result The subjects of the study are of 22 – 49 years old, with equal numbers of both female and male subjects. Conjunctival TGF ß expression was lower in the Mitomycin C group (12,02 ± 3,91) compared with Triamsinolon asetonide group (16,03 ± 8,84) with p value = 0,029. Conclusion There was a statistically significant difference of conjunctival TGF b expression between Mitomycin C and Triamsinolon asetonid on progressive primary pterygium.

Kata Kunci : Pterigium Primer, TGF Beta, Mitomycin C