Perubahan sensitivitas retina pasca operasi perlekatan kembali retina pada ablasi retina regmatogen baru dan lama

ROSE, dr. Angela Nurini Agni, Sp.M, M.Kes

2008 | Tesis | S2 PPDS - Ilmu Kedokteran Klinik

Penelitian ini bertujuan untuk mengetahui perubahan sensitivitas retina tiga bulan pasca operasi pasca operasi ablasi retina regmatogen baru dan lama Studi merupakan studi prospektif. Tiga puluh lima mata (35 pasien) yang telah mengalami keberhasilan anatomi 3 bulan pasca operasi retina ikut serta dalam penelitian. Ablasi retina regmatogen baru adalah bila ablasi retina regmatogen terjadi kurang dari 24 hari sebelum operasi retina dilakukan, sedangkan ablasi retina regmatogen lama adalah bila ablasi retina regmatogen terjadi lebih atau sama dengan 24 hari. Jumlah sampel diperoleh dengan asumsi bahwa perbedaan perubahan sensitivitas retina di antara kedua kelompok adalah 5 desebel. Pemeriksaan sensitivitas retina menggunakan perimeter manual kinetik Goldmann dilakukan pre operasi dan 3 bulan pasca operasi. Tiga puluh lima mata diikutsertakan dalam penelitian ini, 19 mata termasuk dalam kelompok ablasi retina regmatogen baru dan 16 termasuk dalam kelompok ablasi retina regmatogen lama. Semua ablasi retina regmatogen melibatkan makula. Luas ablasi retina antara 4 jam hingga 12 jam. PVR grade A ditemukan pada 2 mata dan PVR grade C pada 2 mata. Dua (5,7%) mata dilakukan operasi scleral buckling (SB), satu (2,9%) mata dilakukanSB dan vitrektomi dengan penyuntikan minyak silikon, 32 mata (91,4%) dilakukan SB dan vitrektomi dengan penyuntikan gas. Retinotomi dilakukan pada 2 mata dan internal limiting membrane (ILM) peeling dilakukan pada 1 mata. Tiga bulan pasca operasi, perubahan sensitivitas retina pada kelompok ablasi retina regmatogen baru sebesar 6.9 ± 5.57 dB dan pada kelompok ablasi retina regmatogen lama sebesar10.63 ± 6.07 dB dengan nilai p =0,07. Hasil penelitian menunjukkan perubahan sensitivitas retina di antara kelompok ablasi retina regmatogen baru dan lama tidak berbeda bermakna secara klinis dan statistik, namun pada kedua kelompok terdapat perbaikan sensitivitas retina

The purpose of this study was to evaluate the difference of central retinal sensitivity changes after 3-month retinal surgery in new onset and longstanding rhegmatogenous retinal detachment (RRD) This is a prospective study. Thirty five eyes with RRD which showed anatomically successful surgery were included in this study. RRD which was developed more than 24 days prior to surgery was considered as longstanding RRD. Sample size was calculated based on the assumption that clinically significant central retinal sensitivity change was 5 decibels. Central retinal sensitivity was examined by Goldmann manual kinetic perimetry before and 3 months after surgery. There were 35 eyes included in this study, consisted of 19 new onset RRD and 16 longstanding RRD. The macula was involved in all of the subjects. The extent of retinal detachment ranged between 4 clock hours and 12 clock hours. PVR Grade A was found in 2 eyes and Grade C in 2 eyes. Two eyes (5.7%) underwent scleral buckling (SB), one eye (2.9%) SB and posterior vitrectomy using silicone oil, and 32 eyes (91.4%) SB and posterior vitrectomy using gas. Retinotomy was performed in 2 eyes and internal limiting membrane (ILM) peeling in 1 eye. Three months after the surgery, the mean change of central retinal sensitivity for new RRD was 6.9 ± 5.57 dB, and 10.63 ± 6.07 dB for longstanding RRD (p= 0.07). The difference of central retinal sensitivity changes between new onset and longstanding RRD was not clinically as well as statistically significant. However, both groups showed improvement of central retinal sensitivity.

Kata Kunci : Retina,Ablasi retina regmatogen baru,Ablasi retina regmatogen lama,Perimeter manual kinetik Goldmann,Desibel,retinal sensitivity, new onset rhegmatogenous retinal detachment, longstanding rhegmatogenous retinal detachment, manual kinetic Goldmann perimete