Introduction: Purpose, to evaluate patient demographic characteristics, indications and variables related to penetrating keratoplasty (PK) survival. Study design, this study was retrospective case series. Methods: We trace all medical records of PK patients from 2015 to 2018 in Cipto Mangunkusumo Hospital Jakarta. The traced variables were indications of surgery, corneal vascularization, previous failed graft, glaucoma after PK, and other complication. PK survival rate is shown in the Kaplan Meier curve using SPSS v20.0. Results: A total of 214 patients underwent PK (men 67.3%, woman 32,7%) with mean age of 42.11 (0-85) years were included in this study. Three most common indications of keratoplasty were corneal scar (32.7%), infectious corneal ulcer (25.5%), and failed graft (19.2%). The overall graft survival rate for PK is 61.7%. The mean graft survival time was 14.388 ± 0.580 months (95% CI; 13.252-15.524). Conclusion: The graft survival rate for penetrating optic keratoplasty was 61.7%. Establishing an appropriate early diagnosis, reasonable surgical procedures, close monitoring, and early detection of complications with proactive interventions lead to better outcomes. Further research is needed to determine the relationship between the risk factors for corneal graft failure.

Open globe injury is an injury that requires prompt treatment which could predict the final outcome. This study evaluates the characteristics and outcome of corneal rupture management in dr. Cipto Mangunkusumo National Hospital’s emergency room. We conducted a retrospective study based on the patient’s medical record between January 2016 – December 2017. Data regarding patients’ demographic, clinical characteristics according to Birmingham Eye Trauma Terminology Score (BETTS) criteria, duration of trauma to surgery, use of early topical steroid, one month visual function result, and risk of endophthalmitis were collected. A repeated ANOVA test with posthoc Bonferroni was used to compare the mean of a paired numeric variable. A total of 163 patients with corneal rupture were recorded, consisted of mostly male (92%) and median age of 27 years old. We found 36.8% cases occurred in the household, 71% cases in the zone I, 62.6% penetrating cases, and mostly came with 4/200-light perception visual acuity (VA) for all zones, mostly caused by inorganic materials and 50.9% cases involved lens. Endophthalmitis was higher in inorganic causes (69.2% vs 30.8%, p=0.33). A total of 95.2% of cases performed surgical treatment in < 24 hours. In post-operative follow up, 53.3% of cases did not need re-operation or proceeding surgery. Several risk factors might affect the treatment outcome of eye injury. Most rupture occurred at zone I. Administration of topical steroids directly post-surgery was not associated with the incidence of endophthalmitis.

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Introduction: To highlight the therapeutic dilemma in managing complications in high myopia patient with complicated cataract after vitrectomy who previously had refractive surgery. Case Report: A 37-years old man, presented with half the right eye view was being blocked by a black curtain for one week before admission. He had a history of high myopia on both eyes and underwent phakic intraocular lens (PIOL) implantation 12 years ago. Presenting visual acuity (VA) of the right eye was hand motion (HM). Retinal detachment (RD) on inferior side, and clear lens with anterior chamber (AC) PIOL were found in the examination. Patient underwent vitrectomy, endolaser, and silicone oil in the next four days. A sudden severe pain with red-eye was found one month after surgery, intraocular pressure (IOP) was increased to 43 mmHg, the lens was white opaque with lens material seen in AC. Discussion: The diagnosis of traumatic cataract and lens-particle-induced glaucoma was made. Lens mass evacuation surgery was performed after initial antiglaucoma medication. Posterior capsule rupture was found intraoperatively with only a small amount of lens mass remaining. Visual acuity result after the second surgery is still dissatisfied with the presence of rubeosis iridis, with the possibility of retinal re-detachment was still present. Conclusion: High myopia still poses a greater risk of ocular complications. It can be corrected by refractive surgery, with expensive cost and it will not prevent potential future ocular problems. Repeated assessment before and after refractive surgery procedure is mandatory in order to prevent sight-threatening complications of high myopia which might lead to other blinding complications.

Background: Self-directed learning (SDL) as part of student-centered learning, has been applied in medical education curriculum in Indonesia since the Competency-Based Curriculum was introduced. Students’ perception towards SDL concept in relation to clinical stage and how it is applied are important to identify problems from students’ point of view. This study aimed to see SDL readiness and its correlation to academic achievement; and to obtain student perceptions towards SDL.Methods: A cross-sectional quantitative study was conducted in the Faculty of Medicine Universitas Indonesia (FMUI) from April to June 2013, involving 209 of year 4 students to see SDL readiness and its correlation to academic achievement. Qualitative methods with phenomenological approaches were used to obtain student perceptions of SDL.Results: 71.3% of students were in the category of ready for SDL with a mean score of 57.03 (SD 7.416). Among students’ characteristics, significant mean difference was found in type of education program. The international class group had a higher mean score than the regular group (p 0.014). SDLRS scores did not correlate with student academic grades. Students’ perceptions towards SDL were in accordance with known concepts, and students preferred SDL rather than teacher-centered learning in the clinical stage with suggestions of improvement in some areas.Conclusion: Clinical stage students were ready to conduct SDL. International class students seemed more ready for SDL. Students at year 4 clinical stage had good perception of SDL. This positive perception would provide sufficient readiness for the implementation of SDL in medical education.