Analisis Efektivitas Lensa Intraokular Hidrofilik dan Hidrofobik terhadap Posterior Capsule Opacification Pascaoperasi Katarak

Linda Dimyati; Tri M. Andayani; Ika P. Sari; Rinanto Prabowo

doi:10.15416/ijcp.2020.9.4.317

Analisis Efektivitas Lensa Intraokular Hidrofilik dan Hidrofobik terhadap Posterior Capsule Opacification Pascaoperasi Katarak

Linda Dimyati, Tri M. Andayani, Ika P. Sari, Rinanto Prabowo

Abstract

Komplikasi yang sering terjadi pascaoperasi katarak dengan implantasi lensa intraokular (LIO) adalah Posterior Capsule Opacification (PCO) yang menyebabkan penurunan tajam penglihatan. PCO dapat terjadi beberapa bulan sampai beberapa tahun pascaoperasi. Perkembangan material, desain LIO dan teknik bedah katarak efektif untuk menurunkan angka kejadian atau memperlambat terjadinya PCO. Penelitian ini bertujuan untuk mengetahui efektivitas LIO akrilik hidrofilik dibandingkan LIO akrilik hidrofobik dalam meningkatkan tajam penglihatan, menurunkan kejadian PCO dan Neodymium: Yttrium-Aluminum-Garnet (Nd:YAG) laser 3 tahun pascaoperasi katarak. Penelitian ini merupakan penelitian observasional analitik dengan rancangan kohort retrospektif. Subjek penelitian adalah pasien pascaoperasi katarak dengan implantasi LIO akrilik hidrofilik dan hidrofobik di RS Mata “Dr.Yap” Yogyakarta pada periode Juni 2016–Desember 2018 yang memenuhi kriteria inklusi dan eksklusi serta bersedia ikut dalam penelitian dengan menandatangani surat persetujuan. Pengukuran efektivitas terapi dilakukan melalui peningkatan tajam penglihatan, angka kejadian PCO, dan angka Nd:YAG laser menggunakan uji komparasi Chi-Square, independent t-test (distribusi normal) dan Mann-Whitney (distribusi tidak normal). Hasil menunjukkan bahwa tajam penglihatan tanpa koreksi pascaoperasi katarak mengalami peningkatan sebesar 0,68±0,44 pada kelompok LIO hidrofobik dan 0,56±0,35 pada LIO hidrofilik. Tidak ada perbedaan secara signifikan antara kedua kelompok LIO (p=0,111). Angka kejadian PCO kelompok LIO hidrofobik sejumlah 12 (19,7%) dan LIO hidrofilik yaitu 32 (52,5%) dengan p=0,022, sedangkan angka kejadian Nd:YAG laser pada LIO hidrofobik 3 (4,18%) dan LIO hidrofilik 15 (24,59%) dengan p=0,040. Dapat disimpulkan bahwa kedua LIO sama-sama efektif dalam meningkatkan tajam penglihatan, LIO akrilik hidrofobik lebih efektif dalam menurunkan kejadian PCO dan Nd:YAG laser dibandingkan LIO akrilik hidrofilik.

Kata kunci: Hidrofilik, hidrofobik, katarak, lensa intraokular, posterior capsule opacification

Effectiveness Analysis of Hydrophilic and Hydrophobic Intraocular Lens on Posterior Capsule Opacification After Cataract Surgery

Abstract

Posterior capsule opacification (PCO) is a frequent complication from cataract surgery with intraocular lens (IOL) implantation, is capable of affecting visual acuity (VA), and arises possibly months or years after operation. Furthermore, this is efficiently mitigated with material and design developments of IOL and surgical techniques. This study aimed at comparing the effectiveness of hydrophilic to hydrophobic acrylic IOL to enhance VA and mitigate PCO and Nd:YAG laser occurrence within 3 years after cataract surgery. This research employed analytic observational method and retrospective cohort design. Also, the subjects had experienced cataract surgery and the IOL implantation at “Dr.Yap” Eye Hospital Yogyakarta between June 2016 and December 2018, met the inclusion and exclusion criteria, and gave consent. The effectivity parameters included VA, the PCO incidence, and Neodymium: Yttrium-Aluminum-Garnet (Nd: YAG) laser, analyzed using the Chi-Square test and t-test (normal distribution) and Mann-Whitney test (non-normal distribution). The result indicated hydrophobic and hydrophilic IOL possessed VA elevation of 0.68±0.44 and 0.56±0.35 respectively, with no significant difference between both groups (p=0.111). Also, the PCO occurrence in hydrophobic IOL 12 (19.7%) was significantly lower compared to hydrophilic IOL at 32 (52.5%) (p=0.022), while Nd:YAG laser in hydrophobic IOL was 3 (4.18%) lesser than the hydrophilic IOL, 15 (24.59%) (p=0.040). However, although both IOLs were effective in enhancing VA, hydrophobic IOL was better in mitigating PCO and Nd:YAG laser occurrences compared to hydrophilic IOL.

Keywords: Cataract, hydrophilic, hydrophobic, intraocular lens, posterior capsule opacification

Keywords

Hidrofilik, hidrofobik, katarak, lensa intraokular, posterior capsule opacification

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