Perbandingan Teknik Eksisi Tenon dan Sparing Tenon dalam Bedah Pterigium
DOI:
https://doi.org/10.35790/ecl.v13i3.62515Abstract
Abstract: Pterygium is a fibrovascular overgrowth of the conjunctiva, commonly affecting individuals in their productive age and potentially impairing vision. Tenon excision is hypothesized to reduce recurrence rates more effectively than tenon-sparing techniques. This study aimed to compare the effectiveness and safety of tenon excision versus tenon-sparing techniques in primary pterygium surgery. A prospective, randomized controlled trial was conducted involving 50 patients with grade III–IV primary pterygium. Patients were randomly assigned to either the Tenon excision or tenon-sparing group (25 patients each). Outcomes assessed included recurrence rates, postoperative complications, and patient satisfaction over a 12-month follow-up period. Statistical analysis was performed using SPSS version 26 with significance set at p<0.05. The tenon excision group showed a significantly lower recurrence rate (4%) compared to the tenon-sparing group (28%) (p=0.02). Complications such as flap edema and granuloma were more frequent in the tenon-sparing group. The relative risk of recurrence in the tenon-sparing group was seven times higher than in the excision group. In conclusion, tenon excision is a more effective and safer surgical technique for reducing pterygium recurrence and postoperative complications. It is recommended particularly for patients at high risk of recurrence.
Keywords: pterygium; tenon excision; sparing technique; recurrence; postoperative complications
Abstrak: Pterigium merupakan pertumbuhan fibro-vaskular konjungtiva yang sering mengenai populasi usia produktif dan berpotensi menyebabkan gangguan penglihatan. Teknik eksisi pterigium yang melibatkan pengangkatan kapsul tenon diyakini dapat menurunkan angka kekambuhan secara bermakna dibandingkan teknik yang mempertahankan tenon. Penelitian ini bertujuan untuk membandingkan efektivitas dan keamanan antara teknik eksisi tenon dan teknik sparing tenon dalam pembedahan pterigium primer. Penelitian ini merupakan uji klinis acak terkontrol prospektif yang melibatkan 50 pasien dengan pterigium derajat III dan IV. Peserta dibagi secara acak ke dalam dua kelompok, yaitu kelompok eksisi tenon dan sparing tenon (masing-masing 25 pasien). Evaluasi dilakukan terhadap angka kekambuhan, komplikasi pascaoperasi, dan tingkat kepuasan pasien hingga 12 bulan pascaoperasi. Analisis statistik menggunakan SPSS versi 26 dengan nilai p<0,05 dianggap bermakna. Hasil penelitian mendapatkan kelompok eksisi tenon menunjukkan angka kekambuhan yang jauh lebih rendah (4%) dibandingkan kelompok sparing tenon (28%) dengan perbedaan bermakna secara statistik (p=0,02). Komplikasi seperti edema flap dan granuloma lebih banyak ditemukan pada kelompok sparing tenon. Relative risk kekambuhan pada kelompok sparing ialah 7,0 kali lebih tinggi dibandingkan eksisi tenon. Simpulan penelitian ini ialah eksisi tenon merupakan teknik pembedahan yang lebih efektif dan aman dalam mengurangi kekambuhan pterigium dan komplikasi pascaoperasi dibandingkan teknik sparing. Teknik ini direkomendasikan terutama bagi pasien dengan risiko kekambuhan tinggi.
Kata kunci: pterigium; eksisi tenon; teknik sparing; kekambuhan; komplikasi pascaoperasi
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