Intrastromal injection of voriconazole together with topical voriconazole effectively reduced the infiltration size and controlled the infection in patients with Fusarium keratitis. However, continued application of the topical medication is critical for a favorable outcome of treatment.

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Purpose To study a preferred technique of phacoemulsification in eyes with posterior polar cataract and report its outcome. Methods Under topical anesthesia, phacoemulsification was carried out after hydrodelination in 23 cases (38 eyes) with ages ranging from 19 to 65 years (mean ¼ 33.5 years). Hydrodissection was not performed. Results Mean duration of follow-up was 9.5 months. None of the eyes developed posterior capsule rupture, but seven eyes (18.4%) revealed posterior capsule plaque postoperatively, which needed neodymium : YAG laser capsulotomy. Mean visual acuity improved significantly after surgery (P ¼ 0.0001, paired t-test); In all, 34 eyes achieved a best-corrected visual acuity of 20/40 or more (89.4%). However, the postoperative visual acuity was less than 20/25 in 11 eyes (28.9%). The causes of the low acuity were amblyopia in eight eyes (21.0%) and macular degeneration due to retinitis pigmentosa in two others (5.2%). Conclusion Phacoemulsification is an effective and safe method to treat posterior polar cataract with gentle hydrodelination 'hydrodissection free phacoemulsification technique'. This is especially true when great attention is paid to the 'floppy' posterior capsule. Although previous amblyopia might interfere with excellent surgical outcome in patients with a unilateral or highly asymmetric bilateral cataract, visual acuity improved significantly in most cases.

FG is effective in the closure of corneal perforations up to 2 mm in diameter. Corneal perforation larger than 2 mm may not respond well. It provides fast healing with low rate of corneal vascularization.

PurposeTo evaluate the visual outcomes, pseudoaccommodation, and wavefront aberrometry after implantation of Wichterle IOL-Continuous Focus (WIOL-CF®, Gelmed International, Kamenne Zehrovice, Czech Republic) by i-Trace aberrometry.MethodsIn this retrospective interventional case series study, after cataract surgery with implantation of accommodative WIOL-CF®, the patients were evaluated with i-Trace aberrometer for measurement of modulation transfer function (MTF), point spread function (PSF), total aberrations, higher order aberrations (HOAs) at far and near and pseudoaccommodation. The pre and postoperative visual acuity at near and distance were also measured.ResultsForty eyes of 20 patients (aged 40–77 years) were enrolled in this study with mean follow-up time of up 13.10 ± 5.52 months. The mean logMAR corrected distance visual acuity (CDVA) improved from 0.20 ± 0.14 preoperatively to 0.10 ± 0.09 at the last follow-up after surgery (P = 0.002). The results were 60% J1, 70% J2, 85% J3, 90% J4, 95% J5 and 100% for J6. The mean pseudoaccommodation, range of accommodation volume, and average of peak accommodation were −2.52 ± 1.56 diopters (D), 1.50 to 5.25 D and −3.25 ± 1.25 D, respectively. The mean MTF at 5 cycles per degree at far was 0.200 ± 0.10 and for near was 0.207 ± 0.10. PSF at far and near was 0.0002 and 0.001, respectively. The mean root mean square (RMS) value of HOAs; total, coma spherical aberration, trefoil, and secondary astigmatism were 1.08 ± 0.48 μm, 0.89 ± 0.45 μm, −0.33 ± 0.23 μm, 0.25 ± 0.17 μm, and 0.15 ± 0.13 μm for far and 0.88 ± 0.49 μm, 0.73 ± 0.46 μm, −0.25 ± 0.22 μm, 0.19 ± 0.16 μm and 0.11 ± 0.10 μm for near, respectively. There was a decrease in HOAs at near relative to far (P < 0.05).ConclusionWIOL-CF® seems to be an acceptable accommodative intraocular lens (IOL) in terms of uncorrected near and distant visual outcomes, MTF and HOA.

Purpose:To report a surgical approach combining scleral patch graft and tenonplasty for successful management of refractory Pseudomonas scleritis following pterygium removal with mitomycin C application.Case Report:A 75-year-old diabetic woman with a history of prior pterygium excision and mitomycin C application developed infectious necrotizing scleritis caused by Pseudomonas aeruginosa. Owing to progression of scleritis despite medical management, the patient underwent surgery. Intraoperatively, extensive scleral ischemia was noted. Therefore, debridement of the necrotic tissue, scleral graft, tenonplasty to bring blood vessels to the ischemic sclera, and amniotic membrane transplantation were performed. Postoperatively, no signs of ischemia or recurrence of infection were observed. During 6 months of follow-up, the patient achieved complete restoration of the globe integrity with a non-inflamed ocular surface.Conclusion:Through restoration of blood supply to the ischemic sclera, tenonplasty is an effective adjunctive procedure in addition to conventional scleral patch graft for the treatment of refractory Pseudomonas scleritis associated with ischemia.

PurposeTo evaluate the effect of the femtosecond laser-assisted MyoRing implantation on the confocal biomicroscopic findings in different corneal layers of the patients with keratoconus.MethodsTwelve eyes of 12 patients with mild to moderate keratoconus (keratometry between 48 and 52 diopters) and intolerance to hard contact lens entered the study. All the included patients underwent femtosecond laser-assisted MyoRing (Dioptex GmBH, Linz, Austria) implantation. The confocal biomicroscopy of the cornea was performed for all corneal layers in the center and periphery preoperatively and 3 and 6 months postoperatively. The cell counts and the qualitative findings in each layer of the cornea were compared between preoperative and 3 and 6 months postoperative images.ResultsCompared with preoperative values, the central epithelial and the central and peripheral midstromal cell counts were significantly decreased 6 months after MyoRing implantation (P = 0.015, P = 0.010 and 0.005, respectively). Furthermore, compared with preoperative values, the peripheral posterior stromal cell count was significantly decreased 3 months after MyoRing implantation (P = 0.033). In the qualitative analysis, highly reflective nuclei in the basal epithelium, transient disruption in the subepithelial nerve plexus, increase in the reflectivity of the stromal keratocyte, and normal endothelial cell morphology were seen.ConclusionsOur study demonstrated some findings similar to that reported in intrastromal corneal ring segments (ICRS): decreased central epithelial cell counts, highly reflective nuclei in the basal epithelium, transient disruption in the subepithelial nerve plexus, and normal endothelial cell count and morphology. In addition, a decrease in the central and peripheral midstromal, transient decrease in posterior stromal cell counts, and absence of amorphous depositions were in contrast with the findings reported in ICRS.

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