ANALISIS KINERJA KEUANGAN DAN STRATEGI BISNIS MANAJEMEN PADA PERUSAHAAN BIG BUBBLE DIVE DI GILI TRAWANGAN

PT. Big Bubble Dive adalah perusahaan yang bergerak di bidang jasa menyelam di Gili Trawangan, Provinsi Nusa Tenggara Barat. Namun, ketatnya persaingan memaksa PT. Big Bubble Dive untuk memaksimalkan kinerja perusahaan dan menentukan manajemen strategi yang tepat. Tujuan dari penelitian ini adalah untuk menganalisa kinerja keuangan perusahaan periode 2015-2018 menggunakan ratio keuangan seperti Current Ratio, ROA, ROE dan Debt-Equity Ratio serta untuk menentukan strategi bisnis manajemen perusahaan menggunakan Matriks SWOT, Matriks IFAS, Matriks EFAS dan Matriks IE. Hasil penelitian menujukan bahwa rasio keuangan PT. Big Bubble Dive periode 2015-2018 pada Current Ratio, yaitu 1.443% tahun 2015, 921% tahun 2016, 1.344% tahun 2017, dan 1.770% tahun 2018, ROA sebesar 7,51% tahun 2015, 3,29% tahun 2016, 9,61% tahun 2017, dan 12,74% tahun 2018, ROE sebesar 34,81% tahun 2015, 3,96% tahun 2016, 13,14% tahun 2017 dan 24,53% tahun 2018, Debt-Equity Ratio sebesar 402,21% tahun 2015, 41,97% tahun 2016, 40,01 tahun 2017 dan 94,23% tahun 2018. Strategi bisnis manajemen yang ditetapkan adalah strategi intensif yang meliputi penetrasi pasar dengan memperluas market share melalui pemasaran atau promosi maupun pengembangan produk atau jasa agar tidak terjadi kejenuhan.

Features of the formation of "Big Bubble" during deep anterior lamellar keratoplasty

Purpose. To determine the optimal channel parameters in the deep layers of the corneal stroma when performing deep anterior lamellar keratoplasty (DALK), providing the maximum frequency of air bubble formation, under the control of intraoperative optical coherence tomography. Material and methods. The study was performed at 30 patients (30 eyes) with a diagnosis of stage III keratoconus. The average age of patients is 31±7 years. All patients were divided into groups consisting of 10 patients, depending on the choice of the topographic orientation of the channel for pneumodissection in the deep layers of the corneal stroma when performing DALK: 1st group – the channel is located towards the center of the cornea; 2nd group – the channel is located paracentral to the temporal side; 3rd group – the channel is located paracentral to the nasal side. In all cases, DALK was performed with a femtosecond laser Femto LDV Z8 (Ziemer, Switzerland). The length of the formed femto channels were variable and amounted to 1.0, 1.5, 2.0, 2.5 and 3.0 mm in each group. Results. The use of intraoperative OCT demonstrated that in all 30 cases the depth of the channel for pneumodissection corresponded to preoperative calculations and amounted to 97±5µm to DM. It was found that the bedding of the channel at a distance of 100µm to the descemet membrane (DM) and its paracentral orientation is characterized by a greater frequency of formation of the «Big Bubble» in comparison with its central orientation: 3rd group – 90% and 2nd group – 80% against 1st group – 60% of cases. The study of the effect of the length of the channel for pneumodissection on the ease of formation of the "Big Bubble" demonstrated that more attempts are required to inject sterile air when channels of 2.0, 2.5, 3.0 mm being used than with short channels of 1.0, and 1, 5 mm (average 3 attempts versus 1.5 attempts, respectively). Conclusion. The paracentral orientation of the location of the channel for pneumodissection is accompanied by a higher percentage of formation of the "Big Bubble" than the central location of the channel. Manual extension of femtochannels having length of 1.0, 1.5 mm, directly with a microsurgical spatula 30G followed by inserting a metal cannula into the channel minimizes the number of attempts to inject sterile air, that facilitates the formation of the "Big Bubble". Performing DALK applying the function of intraoperative OCT allows to control the accuracy of all stages of the operation, including the stage of formation of a large air bubble. Performing DALK with the applying of the function of intraoperative OCT allows to control the accuracy of all stages of the operation, including the stage of formation of a large air bubble. Key words: deep anterior lamellar keratoplasty, Big Bubble, channel for pneumodissection

A deep learning approach for successful big-bubble formation prediction in deep anterior lamellar keratoplasty

The efficacy of deep learning in predicting successful big-bubble (SBB) formation during deep anterior lamellar keratoplasty (DALK) was evaluated. Medical records of patients undergoing DALK at the University of Cologne, Germany between March 2013 and July 2019 were retrospectively analyzed. Patients were divided into two groups: (1) SBB or (2) failed big-bubble (FBB). Preoperative images of anterior segment optical coherence tomography and corneal biometric values (corneal thickness, corneal curvature, and densitometry) were evaluated. A deep neural network model, Visual Geometry Group-16, was selected to test the validation data, evaluate the model, create a heat map image, and calculate the area under the curve (AUC). This pilot study included 46 patients overall (11 women, 35 men). SBBs were more common in keratoconus eyes (KC eyes) than in corneal opacifications of other etiologies (non KC eyes) (p = 0.006). The AUC was 0.746 (95% confidence interval [CI] 0.603–0.889). The determination success rate was 78.3% (18/23 eyes) (95% CI 56.3–92.5%) for SBB and 69.6% (16/23 eyes) (95% CI 47.1–86.8%) for FBB. This automated system demonstrates the potential of SBB prediction in DALK. Although KC eyes had a higher SBB rate, no other specific findings were found in the corneal biometric data.

A Deep Learning Approach for Successful Big-bubble Formation Prediction in Deep Anterior Lamellar Keratoplasty

The efficacy of deep learning in predicting successful big-bubble (SBB) formation during deep anterior lamellar keratoplasty (DALK) was evaluated. Medical records of patients undergoing DALK at the University of Cologne, Germany between March 2013 and July 2019 were retrospectively analyzed. Patients were divided into two groups: (1) SBB or (2) failed big-bubble (FBB). Preoperative images of anterior segment optical coherence tomography and corneal biometric values (corneal thickness, corneal curvature, and densitometry) were evaluated. A deep neural network model, Visual Geometry Group-16, was selected to test the validation data, evaluate the model, create a heat map image, and calculate the area under the curve (AUC). This pilot study included 55 patients overall (12 women, 43 men). SBBs were more common in keratoconus eyes (KC eyes) than in corneal opacifications of other etiologies (non KC eyes) (p = 0.001). The AUC was 0.746 (95% confidence interval [CI]: 0.603–0.889). The determination success rate was 78.3% (18/23 eyes) (95% CI: 56.3-92.5%) for SBB and 69.6% (16/23 eyes) (95% CI: 47.1–86.8%) for FBB. This automated system demonstrates the potential of SBB prediction in DALK. Although KC eyes had a higher SBB rate, no other specific findings were found in the corneal biometric data.

A Simple Technique for Descemet Membrane Exposure in Deep Anterior Lamellar Keratoplasty Using the Transconjunctival Single-plane Sclerocorneal Incision

Background: To describe a simple technique for Descemet membrane exposure during deep anterior lamellar keratoplasty (DALK).Methods: As a prospective interventional case series, consecutive patients who underwent DALK were enrolled. The technique involved the separation of the Descemet membrane by injecting air and ophthalmic viscosurgical devices from the point where transconjunctival single-plane sclerocorneal incision with the slit knife is terminated prior to perforation using a mirror image. Descemet membrane exposure success rates and the incidence of intra- and postoperative complications were analyzed. Outcomes of successful DALK procedures, which were not converted to penetrating keratoplasty, were analyzed by evaluating best corrected visual acuity (BCVA; converted to logarithm of the minimum angle of resolution [logMAR]) and graft survival.Results: We included 11 eyes from 11 patients (seven males and four females; 53.6 ± 16.1 years; mean follow-up duration, 26.1 weeks [6–51 weeks]). Ten surgeries were successful in Descemet membrane exposure without rupture, eight were successful in big-bubble formation, and two were finally successful in Descemet membrane exposure after a failed big-bubble. The DALK procedure for only one eye was converted to a penetrating keratoplasty owing to a tear in the Descemet membrane. BCVA improved from 0.83 ± 0.38 logMAR preoperatively to 0.24 ± 0.12 logMAR postoperatively (n=10, p < 0.001). There was no primary graft failure.Conclusion: This simple technique of transconjunctival single-plane sclerocorneal incision could be very useful for exposing the Descemet membrane during DALK.