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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

Bevacizumab intravitreal injection (IVB) could be detected in plasma that might cause an imbalance in the coagulation system. A hypercoagulable state is potentially involved in the risk for thrombosis, which is associated with high cardiovascular mortality.The objective of the current study was to investigate the risk of elevated plasma fibrinogen levelsin hypertensive and normotensive patients after IVB in diabetic retinopathy. This study was conducted at Dr. Sardjito General Hospital, Yogyakarta from March to June 2019. A total of 64 patients were enrolled in the study, included of 32 hypertensive and 32 nonhypertensive patients with diabetic retinopathy who underwent IVB. Patients were interviewed and investigated for physical condition and opthalmological examination. Fibrinogen levelwas measured before and 1 week after IVB. The mean fibrinogen level beforeand after IVB was slightly high in hypertensive patients than normotensive but not significantly different(p>0.05). There was no significant risk of increased fibrinogen levels after IVB in the hypertension group compared to the normotension group in diabetic retinopathy patients. The proportion of patients at high risk for cardiovascular disease after IVB was not significantly different between both groups.

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