In this study, we compared the effectiveness (comparison of post-operative visual acuity/VA) of phacoemulsification by ophthalmologists versus manual small incision cataract surgery (mSICS) by residents in a mass cataract surgery setting. This research was a cross-sectional study of 1137 cataract patients who underwent cataract surgery by ophthalmologists and residents in outreach eye camps during 2015-2017 (3 years). There were 554 patients who underwent phacoemulsification by ophthalmologists and 583 patients who underwent mSICS by residents. Basic patient characteristics data, such as: age, sex and pre-surgical VA were recorded and we compared pre- versus post-operative VA (best corrected VA/BCVA) and surgical adverse events in 4 weeks post-operative follow-up. In basic subject characteristics, there were no differences in age and sex between the 2 groups, in which 602 (52.9%) were men and 535 (47.1%) were women. Overall 583 (51.3%) eyes received mSICS and 554 (48,7%) eyes received phacoemulsification. Visual acuity improvement (≥6/18) was achieved in 59.61% of eyes after phacoemulsification and 53.5% eyes after mSICS. There were no statistical differences in visual outcome results between both groups (p=0.10). Severe surgical adverse events (nucleus drop and endophthalmitis) were found in 3 cases (0.26%) and choroidal bleeding in 1 eye (0.08%). The effectiveness of phacoemulsification and mSICS in improving visual acuity was found similar between ophthalmologists and residents. mSICS should be considered for more frequent use in high volume mass cataract surgery.KEYWORDS cataract surgery; phacoemulsification; manual small incision cataract surgery; outreach program; community ophthalmology

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AIM: The main aim of surgery in pituitary macroadenoma are restoration of visual acuity and visual field defects by decompression of the optic chiasm. Pituitary macroadenoma has slow growth pattern. This study describes the visual status of patients with pituitary macroadenoma and the post operative results. METHODS: Retrospective, descriptive interventional study of patients with pituitary adenoma underwent transphenoid surgery at Dr Sardjito General Hospital, Yogyakarta. RESULTS: There were 7 patients age 29-65 years old, mean age was 42 years old, consist of 3 male and 4 female and  were followed-up varies between 1 until 6 months. There was history of previous transphenoid surgery in 1 patients. Duration of patient’s complaint varies between 1 until 36 months and the mean duration was 12 months. In 6 patients there were bitemporal hemianopia and 1 patients had general depression visual field defect. Visual acuity pre operative was between 0,003 until 1,0 , and the mean visual acuity was 0,1 (right eye) and 0,18 (left eye). Visual acuity post operative was between no light preception until 1,0 , and the mean visual acuity was 0,27 (right eye) and 0,19 (left eye) but there were no statistically significant differences. Fundus examination reveal optic atrophy in all patients. CONCLUSION: Transphenoidal surgery is the treatment of choice in patients with pituitary macroadenoma.  Prolonged duration of symptoms and delay of surgery may impact the visual status KEYWORDS: Visual status, visual field defect, pituitary macroadenoma, transphenoid surgery, post operative

Objective: Severe corneal ulcer requires immediate intensive topical antibiotics, although potentially toxic to corneal epithelium and may contribute for prolonged corneal epithelial defect. Fresh-amniotic membrane transplantation (F-AMT) could act as an adjuvant therapy that counterbalances the epithelial toxicity effect and exerting antimicrobial actions. This study evaluates the clinical improvement and factors associated with the success rate of F-AMT using suturing technique. Methods: This was a retrospective cohort study of 28 patients (28 eyes) conducted at Dr Sardjito General Hospital, Yogyakarta. Inclusion criteria were patients with severe corneal ulcer unresponsive to conventional medical treatment who underwent multilayer F-AMT using suturing technique. Clinical improvement such as hypopyon, size of the corneal defect, and antibiotic medication were evaluated. Results: Corneal epithelial healing was effectively restored at 25 days post F-AMT. There were statistically significant difference in patient’s blepharospasm (p= 0,00) and pain scale postoperative (p=0,00). There was no significant difference in patients visual acuity postoperative. Factors such as the size of the corneal defect, hypopyon, leucocyte count and neutrophil count were not correlated to epithelial healing. Failure was noted in 7 patients (25%) because of a persistent corneal defect. No patient developed major immediate postoperative complications. Conclusion: F-AMT could be an optional adjuvant therapy with excellent results to treat non-healing severe corneal ulcer unresponsive to medical treatment by promoting epithelial healing.