Case Report Presbiopia

7/24/2019 Case Report Presbiopia

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P E M B I M B I N G :D R . R A H A S I A H TA U F I K , S P . M ( K )

CASE REPORT

PSEUDOPHAKIA ODSDENGANPRESBIOPIA HIPERMETROP


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IDENTITAS

Nama: Tn. B

Umur : 70 Tahun

Jn!" K#am!n : $a%!a%!

A'ama : I"#am Su%uBan'"a : Ma%a""ar

P%raan : &

A#ama* : G+a

N+. R'!"*r : 07 - -/Tan''a# Pr!%"a : S1*m2r 30

Tm1a* Pr!%"a : Ba#a! K"ha*an Ma*a Ma%a""ar

Pmr!%"a : 4r. Purnaman!*a S5aa#, S1. M


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ANAMNESIS

K#uhan U*ama : Pn'#!ha*an Ka2ur 1a4a %4ua ma*a

Anamn"!" Tam2ahan : Pa"!n 4a*an' 4n'an %#uhan%a2ur 1a4a %4ua ma*a. K#uhan 4!a#am! "u4ah "a% #ama 6/ *ahun 5an' #a#u. Aa#n5a 1a"!n mn'#uh%an ma*a %anan

*!4a% 4a1a* m#!ha* 4n'an 2a!% 4an *#ah 4!#a%u%an +1ra"!%a*ara% 4an 1ma"an'an I$. S4an'%an ma*a %!r! "u4ah4!ra"a%an "a% 6 / *ahun 5an' #a#u. Pn'#!ha*an %a2ur 1a4ama*a %!r! 4!ra"a%an 1r#ahanahan, aa#n5a 1a"!nmn'#uh%an 1n'#!ha*an 2ra"a1 4an "!#au (8). Pa"!n

2r+2a* % 4+%*r "aa* !*u 4an 4! 4!a'n+"!" %a*ara%. D+%*r1a4a "aa* !n! mn5aran%an un*u% m#a%u%an +1ra"!. Pa"!n*#ah mna#an! +1ra"! %a*ara% 1a4a *ahun 30-. R!a5a*1n''unaan %a9ama*a (8) 5a!*u %a9ama*a un*u% m#!ha*4%a* 4an auh. R!a5a* 1n5a%!* "1r*! *%anan 4arah*!n''!, %n9!n' man!" a*au1un a#r'! 4!"an'%a# +#h 1a"!n.


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PEMERIKSAAN PTHA$M$G

+9u#! 4;*ra S +9u#! "!n!"*ra S


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INSPEKSI

Pemeriksaan OD OS

Palpebra E4ma (&) E4ma (&)

Aparatus akrimal $a%r!ma"! (&) $a%r!ma"! (&)

Silia N+rma# N+rma#

K!n"un#ti$a Bulbi Dr5 5 (&) Dr5 5 (&)

Mekanisme Muskular N+rma#, % "'a#a arah N+rma#, % "'a#a arah

K!rnea Ar%u" "n!#!" (8) Ar%u" Sn!#!" (8)

BMD K"an n+rma# K"an n+rma#

Iris


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PA$PASI

Pemeriksaan OD OS

Test Okuler Tn Tn

N%eri tekan(&) (&)

Massa Tum!r (&) (&)

Glan&ula Preaurikuler Pm2"aran (&) Pm2"aran (&)


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Pemeriksaan 'isus

>D : 30-0 S: 8 0,7 D3030

>S : 300= Ph (&) S: 80,7 D 3030

Pr"2!+1 : AS : 0 ? 8 /,00 AS 3

T!n!meter Applanasi G!l&man

TD : T!4a% 4!#a%u%an 1mr!%"aan

TS : T!4a% 4!#a%u%an 1mr!%"aan

C!l!r Sense

T!4a% 4!#a%u%an 1mr!%"aan


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PENINARAN B$IK

Pemeriksaan OD OS

K!n"un#ti$a Dr5 5 (&) Dr5 5 (&)

K!rnea Ar%u" "n!#!" (&) Ar%u" Sn!#!" (&)

BMD N+rma# N+rma#

Iris


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S$IT $AMP

SOD ( K+nun9*!a *am1a% %r!n', %+rnarn!h 4an *!4a% *am1a% ar9u" "n!#!", BMD %"ann+rma#, !r!" 9+%#a* 4n'an %r!1* (8), 1u1!# 2u#a*,

#n"a rn!h *am1a% a4an5a I$. SOS ( K+nun9*!a *am1a% %r!n', %+rnarn!h 4an *!4a% *am1a% ar9u" "n!#!", BMD %"ann+rma#, !r!" 9+%#a* 4n'an %r!1* (8), 1u1!# 2u#a*(u14+n 1u1!#), #n"a rn!h *am1a% a4an5a I$.


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RESUME

S+ran' 1a"!n #a%!a%! 2rumur 70 *ahun, 4n'an %#uhan%a2ur 1a4a %4ua ma*a. K#uhan 4!a#am! "u4ah "a% #ama 6/ *ahun 5an' #a#u. Aa#n5a 1a"!n mn'#uh%an ma*a %anan*!4a% 4a1a* m#!ha* 4n'an 2a!% 4an *#ah 4!#a%u%an +1ra"!

%a*ara% 4an 1ma"an'an I$. S4an'%an ma*a %!r! "u4ah4!ra"a%an "a% 6 / *ahun 5an' #a#u. Pn'#!ha*an %a2ur 1a4ama*a %!r! 4!ra"a%an 1r#ahanahan, aa#n5a 1a"!nmn'#uh%an 1n'#!ha*an 2ra"a1 4an "!#au (8). Pa"!n2r+2a* % 4+%*r "aa* !*u 4an 4! 4!a'n+"!" %a*ara%. D+%*r

1a4a "aa* !n! mn5aran%an un*u% m#a%u%an +1ra"!. Pa"!n*#ah mna#an! +1ra"! %a*ara% 1a4a *ahun 30-. R!a5a*1n''unaan %a9ama*a (8) 5a!*u %a9ama*a un*u% m#!ha*4%a* 4an auh. R!a5a* 1n5a%!* "1r*! *%anan 4arah*!n''!, %n9!n' man!" a*au1un a#r'! 4!"an'%a# +#h 1a"!n.


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Pa4a 1mr!%"aan +=*a#m+#+'! "9ara !n"1%"! 4an1a#1a"! 1a4a DS 4!4a1a*%an %+nu9*!a %r!n' (8),%+rna *!4a% *r4a1a* ar%u" "n!#!" 1a4a D, 1u1!#

DS 2u#a*, "r*a 1a4a #n"a DS 1"u4+=a%!a. Pa4a1mr!%"aan r=ra%"! >D 30-0 4an >S 300=Ph (&), Pr"2!+1 : AS : 0 ? 8 /,00 AS 3. Pmr!%"aan*+n+m*r! *!4a% 4!#a%u%an 1mr!%"aan. S4an'%an1a4a 1mr!%"aan "#!* #am1 4! 4a1a*%an %+nun9*!a

DS *am1a% %r!n', %+rna *!4a% *r4a1a* ar9u""n!#!" 1a4a DS, Pu1!# DS 2u#a*, "r*a *r4a1a*1nanaman I$ 1a4a DS (P"u4+1ha%!a).


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DIAGNSIS

P"u4+1ha%!a DS 4n'anPr"2!+1! H!1rm*r+1


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TERAPI


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TINJAUAN PUSTAKA

P"u4+1ha%!a

Pr"2!+1! H!1rm*r+1


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ANATMI $ENSA


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DEFINISI

Ka*a %a*ara% 2ra"a# 4ar! 2aha"a #a*!n.


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KATARAK SENI$

Ka*ara% "n!# a4a#ah %a*ara% 1r!mr 5an' *ra4!1a4a u"!a #2!h 4ar! 0 *ahun. Namun, !%a 4!"r*a!4n'an 1n5a%!* #a!nn5a "1r*! 4!a2*" m##!*u"

5an' a%an *ra4! #2!h 91a*. K4ua ma*a 4a1a**r#!ha* 4raa* %%ruhan 5an' "ama a*au2r24a.C


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EPIDEMI$GI

Pnuaan mru1a%an 1n52a2 %a*ara% 5an'*r2an5a%. Ka*ara% a%!2a* 1nuaan mru1a%an1n52a2 umum 'an''uan 1n'#!ha*an. Br2a'!

"*u4! 9r+"" "9*!+na# m#a1+r%an 1ra#n"! %a*ara%1a4a !n4!!4u 2ru"!a &7- *ahun a4a#ah "2an5a%0. Pra#n"! !n! mn!n'%a* h!n''a 70 1a4a!n4!!4u 4!a*a" 7 *ahun. Ka*ara% 5an' *ra4!a%!2a* u"!a #anu* 2r*an''un' aa2 a*a" -C

%2u*aan 5an' *ra4! 4!4un!a 5an' ma%!#! Cu*a !a, mnuru* H. T!4a% a4a 1r24aan ra"4an n!" %#am!n *rha4a1 1nurunan 1n'#!ha*an..


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K$ASIFIKASI KATARAK SENI$

Br4a"ar%an ma*ur!*a", 5a%n! "2a'a! 2r!%u* :

"*a4!um !n"!1!n*

sta&ium imatur

"*a4!um ma*ur "*a4!um h!1rma*ur

Br4a"ar%an m+r=+#+'!"n5a, 5a%n! "2a'a! 2r!%u* :

%a*ara% "u29a1"u#ar

%a*ara% nu9#ar

%a*ara% 9+r*!9a#


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Pa4a "*a4!um !n! #n"a 5an' 4'nra* mu#a!mn5ra1 9a!ran ma*a %4a#am #n"a "h!n''a#n"a mna4! #2!h 9m2un'. Pa4a "*a4!um !n!*ra4! 1m2n'%a%an #n"a 5an' 4!"2u* "2a'a!%a*ara% !n*um"n. Pa4a "*a4!um !n! 4a1a* *ra4!m!+1!"a"! a%!2a* #n"a ma*a mna4! 9m2un',"h!n''a 1a"!n mra"a *!4a% 1r#u %a9ama*a"a%*u mm2a9a 4%a*. A%!2a* #n"a 5an'

2n'%a%, !r!" *r4+r+n' % 41an, 2!#!% ma*a 4an'%a#4an "u4u* 2!#!% ma*a a%an "m1!* a*au *r*u*u1.Pa4a "*a4!um !n! 4a1a* *ra4! '#au9+ma "%un4r.C


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Ka#au *!4a% a4a %%ruhan 4! #n"a, ma%a "!nar4a1a* ma"u% % 4a#am ma*a *an1a a4a 5an'4!1an*u#%an. #h %arna %%ruhan 4!2a'!an

1+"*r!+r #n"a, ma%a "!nar +2#!% 5an' mn'n!2a'!an 5an' %ruh !n!, a%an 4!1an*u#%an "h!n''a1a4a 1mr!%"aan, *r#!ha* 4! 1u1!#, a4a 4arah5an' *ran' "2a'a! r; 1man*u#an 9aha5a1a4a 4arah #n"a 5an' %ruh 4an 4arah 5an'

'#a1, a%!2a* 2a5an'an !r!" 1a4a 2a'!an #n"a 5an'%ruh. Ka4aan !n! 4!"2ur !r!" "ha4+ *"* (8).


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PENATA$AKSANAAN

R


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BEDAH KATARAK

Intra#apsular Catara#t E)tra#ti!n *ICCE+


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E,TRACAPSUAR CATARACT E,TRACTION*ECCE+


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PHACOEMUSI-ICATION *PHACO+


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SMA INCISION CATARACTSURGER. *SICS+

In"!"! 4!#a%u%an 1a4a "%#ra 4n'an u%uran !n"!"!2rar!a"! 4ar! &C mm. Namun **a1 4!%a*a%anSI


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INDIKASI PERASI

In4!%a"! %#!n!" : 2!#a %a*ara% ma*ur,un*u% mn9'ah 1n5u#!* 5an'

4!*!m2u#%an In4!%a"! "+"!a# : 2!#a %%ruhan #n"a*!4a% 4a1a* #a'! m#a%u%an 1%raan"har!&har!


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KNTRAINDIKASI PERASI

In=%"! "%!*ar ma*a "*#ah 4!#a%u%an an# *"*

T%anan 2+#a ma*a 9u%u1 *!n''!

Fun'"! r*!na haru" 2a!%

Ka4aan umum haru" 2a!% ( *!4a% a4a r!a5a*h!1r*n"!, 4!a2*" m##!*u", 4an 2a*u% %r+n!")


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KMP$IKASI BEDAH KATARAK

K+m1#!%a"! ma5+r "#ama +1ra"! :

Ru1*ur %a1"u# #n"a (2!a"an5a 1a4a I


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PSEUDOPHAKIA

P"u4+1ha%!a a4a#ah "ua*u %a4aan 4!manama*a *r1a"an' #n"a *anam "*#ah +1ra"!%a*ara%. $n"a !n! a%an mm2r!%an 1n'#!ha*an

#2!h 2a!%. $n"a !n*ra+%u#r 4!*m1a*%an a%*u+1ra"! %a*ara% 4an a%an **a1 4!"ana un*u%"umur h!4u1. $n"a !n! *!4a% a%an mn''an''u4an *!4a% 1r#u 1raa*an %hu"u" 4an *!4a% a%an4!*+#a% %#uar +#h *u2uh.


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GEJA$A DAN TANDA

Pn'#!ha*an %a2ur

>!"u" auh 4n'an "n##n 9har*

Da1a* mru1a%an m!+1! a*au h!1rm*r+1!

*r'an*un' u%uran #n"a 5an' 4!*anam (I$)Tr4a1a* 2%a" !n"!"! a*au ah!*an


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$*a% #n"a 4! 4a#am 2+#a ma*a 4a1a* 2rma9am&ma9am, "1r*!

Pa4a 2!#!% ma*a 41an, 4!*m1a*%an 4! 41an !r!"4n'an %a%! 1n5+%+n'n5a 2r"an4ar 1a4a "u4u*2!#!% ma*a.

Pa4a 4arah 1u1!# 4!mana 2a'!an mu#*! #n"a 1a4a1u1!# 4n'an %"a"! 1u1!#

Pa4a 2!#!% ma*a 2#a%an', 5an' 4!#*a%%an 1a4a

%4u4u%an #n"a n+rma# 4!2#a%an' !r!". $n"a4!%#uar%an 4n'an %"*ra%"! #n"a %"*ra %a1"u#ar.

Pa4a %a1"u# #n"a


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M#*a%%an #n"a !m1#an* 4! 4a#am 2!#!% ma*ammr#u%an 1rha*!an %hu"u" :

En4+*# %+rna *r#!n4un'

M#!n4un'! !r!" *ru*ama 1!'mn !r!" M#!n4un'! %a1"u# 1+"*r!+r #n"a

Mu4ah mma"u%%ann5a %arna *!4a%mm2r!%an 94ra 1a4a +nu#a #n"a


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Kun*un'an 1ma"an'an #n"a !n! a4a#ah :

Pn'#!ha*an mna4! #2!h "!+#+'!" %arna #*a%#n"a 5an' 4!*m1a*%an 1a4a *m1a* #n"a a"#!

5an' 4!an'%a* $a1an' 1n'#!ha*an "ama 4n'an #a1an'

1an4an'an n+rma#

T!4a% *ra4! 1m2"aran 2n4a 5an' 4!#!ha*

T!4a% *ra4! 1m2"aran 2n4a 5an' 4!#!ha* P"!%+#+'!", m+2!#!"a"! #2!h 91a*


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Pma"an'an #n"a *!4a% 4!anur%an 1a4a :

Ma*a 5an' "r!n' mn'a#am! ra4an' !n*ra +%u#r(u!*!")

Ana% 4!2aah / *ahun U!*!" mnahun 5an' 2ra*

R*!n+1a*! 2ra*

G#au9+ma n+a"%u#ar


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$ENSA INTRAKU$ER (I$)

$n"a !n*ra+%u#r (I$) umum 4!'una%an un*u%mm1r2a!%! 4an mn5m2uh%an 9a9a* !"ua#. I$4!%a*'+r!%an 4a#am 4ua n!" : M+n+=+9a# a*aumu#*!=+9a# #n"a. $n"a m+n+=+9a# a*au mu#*!=+9a#4a1a* 4!man=aa*%an 4a#am 1n''an*!an #n"a ma*aru"a%.


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PRESBIOPIA

Pr"2!+1!a a4a#ah %a4aan r=ra%"! ma*a 4!mana1un9*um 1r+%"!mum ( *!*!% *r4%a* 5an' 4a1a*4!#!ha* 4n'an a%+m+4a"! 5an' ma%"!ma# ) *#ah2'!*u auh "h!n''a 1%raan 4%a* 5an' ha#u""1r*! mm2a9a, mnah!* "u%ar 4!#a%u%an.


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Usia *ta/un+ Kekuatan ensa P!siti0 %an1 &ibutu/kan

23 Ta/un 8,00 D

24 Ta/un 8,0 D

43 Ta/un 83,00 D

44 Ta/un 83,0 D

53 Ta/un 8/,00 D


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DAFTAR PUSTAKA. I#5a" S. Penuntun Ilmu Penyakit Mata Edisi Ketiga. Ja%ar*a. Ba#a! Pnr2!*: Sa'un' S*+,300. 3C&

/3. >au'han DG, A"2ur5 T, R!+4an Ea P. Oftalmologi Umum. E4!"! -. Ja%ar*a: !45a M4!%a 3000.

7&C/

/. N+rman S. Ja, Mar% S. Ja, Gar5 S. Ja. Cataract Surgery and its Complication. E4!"! %#!ma.T+r+n*+ Ph!#a4#1h!a : Th . M+"25

Case Report Presbiopia

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