Tesis

Perbandingan Tingkat Inflamasi Konjungtiva dan Kadar Interleukin-6 Pada Air Mata Pasca Eksisi Pterygium dengan Transplantasi Freeze- Dried Membran Amnion dan Graft Konjungtiva-Limbal = Comparison of Conjunctival Inflammation and Interleukin-6 in Tears After Pterygium Excision With Transplantation of Freeze-Dried Amniotic Membrane and Conjunctival-Limbal Graft .

Penelitian ini bertujuan untuk membandingkan tingkat inflamasi konjungtiva dan kadar interleukin-6 pada air mata pasca eksisi pterygium, dengan transplantasi freeze-dried membran amnion (MA) dan graft konjungtiva limbal (GKL). Penelitian prospektif, intervensional, dengan randomisasi ini melibatkan 26 mata dari 26 subjek yang dilakukan operasi pterygium, dan menerima transplantasi MA atau GKL. Luaran yang dinilai adalah tingkat inflamasi konjungtiva dan kadar interleukin-6 (IL-6) air mata. Seluruh mata (13 mata pada kelompok MA dan 13 mata pada kelompok GKL) dilakukan pemantauan selama 4 minggu. Pada hari ke-7 pasca operasi, hanya 4 (30,8%) mata pada kelompok MA yang mengalami inflamasi berat, sementara sebagian besar (61,5%) mata pada kelompok GKL mengalami inflamasi berat (p=0,59). Pada hari ke-28, tidak ada mata yang mengalami inflamasi berat. Subjek umumnya mengalami inflamasi ringan, yakni 76,9% pada kelomok MA dan 61,5% pada kelompok GKL (p=0,67). Kadar IL-6 meningkat saat hari ke-7, dimana peningkatannya selaras pada kedua keompok (22,85 pg/mL pada kelompok MA berbanding 23,51 pg/mL pada kelompok GKL, p=0,78). Eksisi pterygium dan transplantasi freeze-dried membran amnion secara klinis memberikan inflamasi konjungtiva yang lebih ringan dibandingkan graft konjungtiva-limbal baik pada hari ke-7 maupun hari ke-8 pasca operasi.
Kata kunci: eksisi pterygium, freeze-dried membran amnion, graft konjungtiva- limbal, inflamasi konjungtiva, interleukin-6


This study is aimed to compare conjunctival inflammation and level of interleukin-6 in tears after pterygium excision, with transplantation of freeze dried amniotic membrane (FD-AM) and conjunctival-limbal graft (CLG). This is a prospective, interventional, randomized study involving 26 eyes of 26 subjects who underwent pterygium excision and received either FD-AM or CLG. Outcome measures included conjunctival inflammation and level of tears interleukin-6. Four weeks follow-up was completed in all eyes (13 in AM group and 13 in CLG group). At day 7 th after the surgery, there were only 4 (30.8%) subjects in AM group had severe inflammation, while most subjects (61.5%) in CLG group had severe inflammation (p=0,59). At day 28 th , there was no subject had severe inflammation on both groups. Most subjects presented with mild inflammation, which were 76,9% in AM group and 61,5% in CLG group (p=0,67). The level of IL-6 was increasing at day 7 th , in which the increment was relatively similar in both groups (increasing 22,85 pg/mL in AM group compared to 23,51 pg/mL in CGL group, p=0,78). Pterygium excision and transplantation of freeze-dried amniotic membrane clinically had more subjects with mild inflammation compared to conjunctival-limbal graft, at day 7 th th and 28 after surgery. The level of IL-6 increased in both AM and CLG group at day 7th, and went back to almost the same with baseline level at day 28 th . However there was no significant difference statistically between these 2 groups.
Keywords: pterygium excision, freeze-dried amniotic membrane, conjunctivallimbal graft, conjunctival inflammation, interleukin-6