Ektasia Kornea Pasca Lasik

Nur Shani Meida

Abstract


The objective of this paper to know prevention and management corneal ectasia after Lasik Corneal ectasia after lasik are weakening of cornea caused by central stromal laser or creation of the flap after lasik surgery. This conditions are feared complication of refractive surgeon. Corneal ectasia after lasik will happen several months until several years after lasik. Incidence of corneal ectasia is still unknown, about 1 over 100.000. Diagnosis of corneal ectasia was established by slitlamp appearance of corneal thinning, with progresif miop, progresif irreguler astigmat and refractive error cannot be corrected. Risk factors of corneal ectasia are family history, young age, corneal thickness lower than 500 micron, corneal asymmetri, abnormal topography, keratoconus and low residual stromal bed. The therapeutic options for corneal ectasia are Rigid Gas Permiable (RGP) contact lenses, eye drops for decreased intraocular pressure, corneal collagen crosslinking - riboflavin (C3-R), intacs implantation, and in the advanced stages, lamellar keratoplasty. A complete ophthalmologic examinations before surgery andfindings the risks factors are important to prevent corneal ectasia after lasik. The prognosis of corneal ectasia after lasik was good.

Tujuan penulisan makalah ini untuk mengetahui pencegahan dan pengelolaan ektasia kornea pasca lasik. Ektasia kornea pasca lasik adalah kelemahan kornea akibat ablasi stroma sentral atau pembuatan flap kornea sesudah operasi lasik. Kondisi ini merupakan komplikasi yang paling ditakuti ahli bedah refraktif. Kejadian ektasia kornea pasca lasik dapat terjadi beberapa bulan sampai beberapa tahun pasca lasik. Insidensinya tidak diketahui, diduga sekitar 1 per 100.000. Penegakan diagnosis dilakukan dengan menggunakan slitlamp tampak kornea menipis dan menonjol disertai gejala miop progresif, astigmat irreguler yang meningkat dan kelainan refraksi yang tidak dapat dikoreksi. Beberapa faktor risiko ektasia kornea antara lain riwayat keluarga, umur muda, miop tinggi, ketebalan kornea kurang dari 500 mikron, asimetri kornea, abnormal topografi, keratokonus dan rendahnya residual bed. Beberapa pilihan terapi yang dilakukan yaitu pemakaian lensa kontak RGP, pemakaian obat penurun tekanan intraokuler, pemberian C3-R, implantasi intacs dan tahap lanjut dengan lamellar keratoplasti. Pemeriksaan pre operatif yang lengkap dan penemuan faktor risiko merupakan hal yang penting untuk menghindari terjadinya ektasia kornea pasca lasik. Prognosis pasien ektasia kornea pasca lasik adalah baik.


Keywords


lasik; ektasia kornea; faktor risiko; terapi; prognosis; corneal ectasia; risk factor; therapeutic prognosis

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