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0001), use of iris hooks (P less then 0.0001), and anterior capsulorhexis extension (P less then 0.0001). On the first postoperative day, anterior chamber reaction (P less then 0.0001) and fibrinous membrane (P = 0.0007) were significantly more in the sutured group. Incidence of postoperative complications was 0.98 per sutured eyes (59 complications in 60 eyes). One patient developed endophthalmitis after suture removal. Conclusion Sutureless clear corneal incision in pediatric patients undergoing cataract surgery can achieve stable wound. However, after hydro closure, every wound should be checked for water tightness and the leaky wound should be sutured.Purpose To compare the accuracy of isolated manual marking and smartphone-assisted manual marking with the Verion image-guided system for toric intraocular lens (IOL) implantation. Methods In this prospective observational study, 42 eyes of 36 patients planned for phacoemulsification with toric IOL implantation with corneal astigmatism >1D as measured on Lenstar LS 900 optical biometer were included. Patients were preoperatively registered and photographed on the Verion image-guided system. In the operating room, the patient's eye was manually marked at the 6 o' clock limbus (Manual axis-90°) on slit-lamp in sitting position. Next, using the smartphone android app-iToric Patwardhan, the exact mark axis was confirmed (Smartphone axis). Following this, the patient was taken on the operation table where the mark axis was confirmed with Verion digital overlay on an external screen (Verion axis). The absolute angular deviation of manual axis from Verion was compared with the absolute angular deviation of the smartphone axis from Verion as the primary outcome measure. Results The mean absolute angular deviation between the smartphone axis and the Verion axis was 2.62°, which was significantly lower (P less then 0.05) than that between the manual axis and Verion axis (4.60°). Moreover, the intraclass correlation coefficient between the smartphone axis and Verion axis was 0.88 indicating a strong agreement between the two. Conclusion Smartphone-assisted manual marking significantly improves the accuracy of manual marking alone when comparing with the Verion Digital Marker system for toric IOL implantation.Purpose The aim of the present study was to compare the effects of the preoperative doses of betamethasone acetate 0.1% and placebo on controlling dry eye after cataract surgery. Methods This randomized triple-blind clinical trial was conducted on 62 patients. For the purpose of the study, the participants were assigned into two groups of betamethasone (n = 28) and placebo (n = 34). The groups were administered with drops A or B three days before the operation, four times a day. These drops contained either betamethasone 0.1% or normal saline (placebo). Postoperative follow-up was performed 1, 7, and 30 days after the surgery. Dry eye symptoms were evaluated by means of the ocular surface disease index (OSDI) using the meniscometry test. Repeated measures analysis was also used to study the effect of the interaction between betamethasone and time on meniscometry and OSDI variables. Results A total of 62 patients, including 51.6% female and 48.4% male, were investigated in this study with a mean age o 69.19 ± 12.80 years. The results of the analysis of variance of the repeated measures plot indicated that the OSDI and meniscometry dry eye variables were not affected by the interaction between time and betamethasone (P = 0.192 and P = 0.578, respectively). Conclusion As the findings indicated, the use of betamethasone acetate 0.1% prior to cataract surgery had no significant effect on postoperative dry eye indices.Purpose To assess the corneal endothelium in patients with Fuchs heterochromic iridocyclitis (FHI) and compare it with the normal fellow eye. Methods Retrospective, observational, cross-sectional study of 31 patients seen between Jan 2016 to Dec 2018, with clinical diagnosis of Fuchs heterochromic iridocyclitis, was performed. Specular microscopic examination was documented in both eyes. The affected eyes formed the study group and the fellow healthy eyes served as controls. Results The mean age of the patients was 29.9 ± 8.2 years. The endothelial cell density (P = 0.0001) was significantly lower, whereas average cell size (P = 0.0001), coefficient of variation (P = 0.004), and maximum cell area (P = 0.01) were significantly higher in the affected eye compared to the control eye. In three patients, the affected eye showed guttae, while the healthy fellow eye revealed a normal specular mosaic. Conclusion Specular microscopic analysis shows endothelial alterations in the affected eyes in FHI.Purpose To report and analyze the outcomes of therapeutic deep anterior lamellar keratoplasty (DALK) in patients with advanced Acanthamoeba keratitis (AK). Methods Medical records of microbiologically confirmed AK, underwent DALK from 2004 to 2017, were reviewed and the data related to early and late outcome including complications were retrieved. Outcome of cases with largest diameter of infiltrate ≥8 mm at the time of surgery (advanced keratitis) were analyzed and compared with those with less severe keratitis (infiltrate size less than 8 mm). Results Out of 23 patients of AK in whom DALK was performed, ten (43.4%) patients had advanced keratitis. Mean age of these patients was 38.7 ± 8.6 years (range, 25 to 56). Median visual acuity at presentation was 2.78 (IQR, 1.79-3.0) that improved to 1.79 (IQR, 0.70-2.78) postoperatively. Early complications included recurrence of AK in 2 (20%), Descemet's membrane detachment in 5 (50%), and persistent epithelial defect in 3 (30%) cases. Staurosporine Antineoplastic and Immunosuppressive Antibiotics inhibitor Overall, 6 (60%) grafts failed, whereas 4 (40%) patients had clear graft at their last follow-up. Median follow-up of these cases was 5 months (IQR, 1.4-11.4). One graft developed stromal rejection, which resolved with increased dose of corticosteroids. In comparison, DALK performed for less severe keratitis (N = 13) had 1 (7.6%) recurrence and 2 (15.8%) grafts failure (OR, 8.25). The probability of one-year graft survival and eradication of infection was 32% and 74.1%, respectively, in advanced cases compared to 91.6% and 83.9% in less severe cases. Conclusion Outcome of DALK in advanced Acanthamoeba keratitis is less favorable compared to those carried out for less severe keratitis cases.
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