JURNAL READING

COMPARATIVE EVALUATION OF CONVENTIONAL MEDICAL TREATMENT ALONE VERSUS

CONVENTIONAL MEDICAL TREATMENT WITH AMNIOTIC MEMBRANE TRANSPLANTATION
IN INFECTIVE CORNEAL ULCER

Evaluasi Perbandingan Penatalaksaan Pengobatan Konvensional Saja Dengan Pengobatan

Konvensional dan Transplantasi Membran Amnion pada Infective Cornea Ulcer

Devi Christina Damanik

0100840200
Fakultas Kedokteran Universitas Cendrawasih
SMF Ilmu Penyakit Mata RSUD DOK II Jayapura
Pembimbing :
dr. Esma Kindangen, Sp.M

Evaluasi Perbandingan Penatalaksaan Pengobatan Konvensional Saja

Dengan Pengobatan Konvensional dan Transplantasi Membran Amnion
pada Infective Cornea Ulcer

Abstra
ct :of amniotic membrane transplantation
objective :To compare the effect
along with conventional therapy and the conventional therapy alone for the
treatment of infective corneal ulcer

Methodology:
Non probability purposive sampling
technique was used
Dividing the 68 patients into two groups with the same
number
Group A Conventional treatment alone
Group B Conventional treatment alone+ AMT
The duration of study was 6 months, i.e., from April 2010 to
October 2010,
Data was analyzed by SPSS 10.0. and Chi-square test was used

Evaluasi Perbandingan Penatalaksaan Pengobatan Konvensional Saja

Dengan Pengobatan Konvensional dan Transplantasi Membran Amnion
pada Infective Cornea Ulcer
Results:

Mean age was 500.24 years

Forty six (67.6%) patientswere male while 32.4% (n=22) patients were
female
Conventional Medical Treatment alone was effective in 87% (n=30) cases
while Conventional MedicalTreatment with Amniotic Membrane was
effective in 96% (n=33) cases
P-value 0.03
Conclusion : This study showed encouraging results of amniotic membrane
transplantation along with conventional treatment in corneal ulcer
improving
both symptoms and signs.

in

Evaluasi Perbandingan Penatalaksaan Pengobatan Konvensional Saja

Dengan Pengobatan Konvensional dan Transplantasi Membran
Amnion pada Infective Cornea Ulcer
Introduction :
Corneal ulcer
continues to be sight threatening disease and may lead to
permanent corneal opacity or persistent epithelial defect
In spite of intensive antibiotic treatment,

not reduce the risk of corneal damage

AMT this latter is used a tool to work for the

reconstruction of disturbances in the ocular surface
disorders
AMT certain characteristics like anti-inflammatory, anti-angiogenic,
antiinfective dan anti-fiboblastic useful for the healing of ulcers.
Some studies say that the ATM has been used in cases of epithelial defect,
corneal perforation, limbal stem cell deficiency.

Data on the use of ATMs along with conventional treatment

is still lacking in areas where researchers

Evaluasi Perbandingan Penatalaksaan Pengobatan Konvensional Saja

Dengan Pengobatan Konvensional dan Transplantasi Membran Amnion
pada Infective Cornea Ulcer
Methodology :
Place: Department of Ophthalmology Hayatabad Medical
Complex Peshawar
Time: April 26, 2010-26 October 2010
Number of samples: 68 patients were divided into two groups

Inclusion criteria Patient 15 years old with infectious

corneal ulcers with a size of 3 mm or more

Exclusion criteria Patients with corneal ulcers type of

virus, corneal ulcer perforation, ulcer with endophtalmitis
Group A Conventional treatment alone
Group B Patient with AMT+ Conventional treatment alone
Ratings measure a corneal ulcer starts from day 3 to day 42
post-surgery

Evaluasi Perbandingan Penatalaksaan Pengobatan Konvensional Saja

Dengan Pengobatan Konvensional dan Transplantasi Membran Amnion pada
Infective Cornea Ulcer

Metode
Penelitian :

A full history and examination of the eye was performed in all

patients
Examination using the Snellen chart (to test refaksi), and stlit lamp
to see the anterior segment
ulcer was diagnosed after the patient spilled fluresin and viewed
with a slit lamp.

Statistical analysis Data was analyzed by SPSS 10.0.Mean

and standard deviation to calculate the quantitative
variables such as age. Frequency and presentation was
calculated for qualitative variables such as gender and size
of the ulcer. Chi-square was used to compare ulcer size
berkurangnyanya between age and gender. P value less
than 0.05 was considered significant results...

Evaluasi Perbandingan Penatalaksaan Pengobatan Konvensional Saja

Dengan Pengobatan Konvensional dan Transplantasi Membran Amnion
pada Infective Cornea Ulcer
Result :

Age less than 20 years: 6 patients (9%)

Age 21-30 years: 10 patients (25%)
Age 31-40 years: 14 patients (20%)
Age 41-50 years: 18 patients (26%)
Age 51 060 years: 20 patients (30%)
Mean age of the total sample of 50 0:24 year

46 male patients (67.6%)

22 patients were female (32.4%)

Evaluasi Perbandingan Penatalaksaan Pengobatan Konvensional Saja

Dengan Pengobatan Konvensional dan Transplantasi Membran Amnion
pada Infective Cornea Ulcer
result :

Pre observation operation and post operation of the ulcer

size between the two groups can be seen in Table 1

Group A: 34 patients
In group A showed effective results in 30 cases
(87% ie on 18 male patients and 12 female
patients)
can be seen in Table 2
GROUP B: 34 patients
In group B showed effective results in
33 cases (96%) of 20 men and 13
women

Evaluasi Perbandingan Penatalaksaan Pengobatan Konvensional Saja

Dengan Pengobatan Konvensional dan Transplantasi Membran Amnion
pada Infective Cornea Ulcer
HASIL :

Hasil

Evaluasi Perbandingan Penatalaksaan Pengobatan Konvensional Saja

Dengan Pengobatan Konvensional dan Transplantasi Membran Amnion
pada Infective Cornea Ulcer
Diskusi

Corneal ulcers are more common in males than in females

Basak et al in mpenelitiannya lepaorkan that the incidence of

corneal ulcers occurred in 70.6% of men and 29.4% women

In the study conducted as many as 68% of men experiencing

corneal ulcers and only 32% in women.

Men more work in the field so that the risk of injury to the
cornea vss

Fungal infections nerupakan major cause of ulcers in patients

in the study.

Evaluasi Perbandingan Penatalaksaan Pengobatan

Konvensional Saja Dengan Pengobatan Konvensional dan
Transplantasi Membran Amnion pada Infective Cornea Ulcer

Diskusi
AMT some studies have found that GAME can
help disorder that occurs in the lining of the eye
Pires et al using AMT in 50 cases of bullous
keratopathy 43 (90% 0 eyes free of pain post-op,
45 of 50 eyes cured in just 3 weeks

From the results of the study showed that

patients with AMT showed peninggkatan
better than patients without AMT seen from
the size of the ulcer and the effectiveness of
therapy
AMT does not interfere with the work of anti-

Evaluasi Perbandingan Penatalaksaan Pengobatan

Konvensional Saja Dengan Pengobatan Konvensional dan
Transplantasi Membran Amnion pada Infective Cornea Ulcer

Discussion
The combination of: AMD and

conventional medicine can be used

as a therapeutic modality in the case
of medium-sized ulcer
For more severe cases this
combination can be used as a
temporary therapy

Evaluasi Perbandingan Penatalaksaan Pengobatan Konvensional

Saja Dengan Pengobatan Konvensional dan Transplantasi
Membran Amnion pada Infective Cornea Ulcer

Conclusio
n:

This study showed encouraging results of

amniotic membrane transplantation along with
conventional treatment in corneal ulcer in
improving both symptoms and signs, but small
size of sample was the limiting factor in our
study. Hence large prospective and controlled
trials with more number of patients are required
for better assessment of role of amniotic
membrane transplantation
in addition to conventional medical treatment
in patients with corneal ulcer.