Manual Small Incision Cataract Surgery pada Pasien Katarak dengan Pupil Kecil: Sebuah Laporan Kasus
DOI:
https://doi.org/10.11594/ojkmi.v7i2.85%20Keywords:
Katarak, MSICS, Pupil KecilAbstract
Pendahuluan: Katarak adalah penyebab kebutaan utama di dunia yang dapat dicegah, dan operasi masih merupakan satu-satunya terapi definitif. Manual Small Incision Cataract Surgery (MSICS) merupakan teknik yang banyak digunakan di negara berkembang karena biaya rendah dan efektivitasnya. Pupil kecil adalah salah satu tantangan intraoperatif yang signifikan, terutama di fasilitas tanpa akses penggunaan alat ekspansi pupil.
Laporan kasus: Laki-laki berusia 73 tahun, datang dengan penurunan penglihatan progresif pada mata kanan. Pemeriksaan menunjukkan visus 4/60, dan didiagnosis katarak senilis matur, serta dilatasi pupil maksimal ±5 mm. Operasi dilakukan dengan teknik MSICS menggunakan can-opener capsulotomy, prolaps nukleus, dan manual delivery. Pada hari pertama pascaoperasi, visus meningkat menjadi 6/15 dengan pinhole, dan setelah 1 minggu visus terbaik tercapai 6/10. Komplikasi ringan berupa edema kornea minimal, pupil ireguler, dan sisa korteks kecil yang tidak mengganggu aksis visual.
Pembahasan: Kasus ini menegaskan bahwa MSICS dapat menjadi alternatif yang aman dan efektif pada katarak dengan pupil kecil di fasilitas terbatas. Hasil ini sejalan dengan literatur yang menunjukkan MSICS mampu memberikan perbaikan visus baik tanpa alat ekspansi pupil.
Simpulan: MSICS tetap merupakan teknik penting yang perlu dikuasai, terutama pada kondisi penyulit seperti pupil kecil, karena mampu memberikan perbaikan visus dengan komplikasi minimal.
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