National Medical Commission Bill, 2019 – Good intent but unmet expectations Santosh G Honavar Indian Journal of Ophthalmology 2019 67(8):1259-1260

Cutting corners, or simplifying technology to reach more patients; using the body as its own incubator for epithelial regeneration Virender S Sangwan, Nidhi Gupta, Aastha Singh, Sheila MacNeil Indian Journal of Ophthalmology 2019 67(8):1261-1263

Unilateral enophthalmos Grace L Su, Sara E Lally, Carol L Shields Indian Journal of Ophthalmology 2019 67(8):1264-1264

Simple limbal epithelial transplantation (SLET): Review of indications, surgical technique, mechanism, outcomes, limitations, and impact Swapna S Shanbhag, Chaitali N Patel, Ritin Goyal, Pragnya R Donthineni, Vivek Singh, Sayan Basu Indian Journal of Ophthalmology 2019 67(8):1265-1277 Simple limbal epithelial transplantation (SLET) is an innovative limbal stem cell transplantation technique that has gained increasing popularity over the last few years. Different groups from across the world have published the clinical results of SLET in large case series with varying types and severities of limbal stem cell deficiency (LSCD). This review attempts to place all the available knowledge on SLET together in one place for the benefit of not only cornea specialists and trainees but also for residents and general ophthalmologists. It follows a balanced approach of blending evidence with experience by providing an objective analysis of published results along with helpful insights from subject experts, starting from preoperative considerations including the role of newer imaging modalities to the technical aspects of the surgery itself and the management of possible complications. Original data and novel insights on allogeneic SLET for bilateral LSCD are included in the review to address the few remaining lacunae in the existing literature on this topic. This review intends to inform, educate, and empower all aspiring and practicing SLET surgeons to optimize their clinical outcomes and to have maximal positive impact on the lives of the individuals affected by unilateral or bilateral chronic LSCD.

Commentary: SLET - A paradigm shift in limbal transplantation Jayesh Vazirani Indian Journal of Ophthalmology 2019 67(8):1277-1278

Quality assurance in ophthalmic imaging Suneeta Dubey, Kanika Jain, T Nirmal Fredrick Indian Journal of Ophthalmology 2019 67(8):1279-1287 Quality assurance (QA) is the maintenance of a desired level of quality in a service, by means of attention to every stage of process of delivery. Correct image acquisition along with accurate and reproducible quantification of ophthalmic imaging is crucial for evaluating disease progression/stabilization, response to therapy, and planning proper management of these cases. QA includes development of standard operating procedures for the collection of data for ophthalmic imaging, proper functioning of the ophthalmic imaging equipment, and intensive training of technicians/doctors for the same. QA can be obtained during ophthalmic imaging by not only calibration and setting up of the instrument as per the manufacturer's specifications but also giving proper instructions to the patients in a language which they understand and by acquisition of good quality images. This review article will highlight on how to achieve QA in imaging which is commonly being used in ophthalmic practice.

Commentary: Quality assurance in ophthalmic imaging Harshit Vaidya, Muna Bhende Indian Journal of Ophthalmology 2019 67(8):1288-1288

Microkeratome-assisted ultrathin Descemet's stripping automated endothelial keratoplasty: A randomized trial comparing single-pass versus double-pass technique Namrata Sharma, Aarifa Yasmin Hussain, Ritu Nagpal, Anubha Rathi, Prafulla K Maharana, Rajesh Sinha, Tushar Agarwal, Jeewan Singh Titiyal Indian Journal of Ophthalmology 2019 67(8):1289-1294 Purpose: To compare the outcomes of two techniques, for preparation of microkeratome-assisted ultrathin grafts for Descemet's stripping automated endothelial keratoplasty (DSAEK). Methods: The study involved 20 eyes of 20 patients with pseudophakic bullous keratopathy, randomized into two groups. Group 1 eyes underwent microkeratome-assisted DSAEK using the single-pass technique for lenticule preparation, whereas group 2 eyes underwent microkeratome-assisted DSAEK using the double-pass technique. Patients were followed up till 6 months, postoperatively. Best-corrected visual acuity (BCVA) at final follow-up was considered as the primary outcome measure, whereas graft thickness (GT) contrast sensitivity and endothelial cell loss were considered as the secondary outcome measures. A P value of <0.05 was considered as statistically significant. Results: Baseline characteristics of two groups were comparable. The mean central GT was comparable in both groups at 6 months follow-up [group 1: 98 ± 24.46 μm, group 2: 129 ± 31.46 μm (P = 0.18)]. Both groups fared equally in terms of BCVA (P = 0.33). Contrast sensitivity was significantly better in group 1 eyes (P = 0.045). A statistically significant negative correlation was found between postoperative BCVA and postoperative GT (R = −0.728, P = 0.016). The percentage endothelial cell loss was slightly higher in group 2 eyes, although not statistically significant. Two eyes in group 2 experienced complications during lenticule preparation. None of the eye experienced any complication in the postoperative period. Conclusion: Both techniques provided grafts with comparable thickness and endothelial cell loss and were associated with comparable BCVA, at final follow-up visit. The contrast sensitivity was, however, better in eyes receiving grafts prepared with the single-pass technique.

Commentary: Ultrathin Descemet's stripping automated endothelial keratoplasty Abhishek Dave, Manisha Acharya Indian Journal of Ophthalmology 2019 67(8):1294-1295

Commentary: Microkeratome-assisted ultrathin Descemet's stripping automated endothelial keratoplasty Hariprasad Vokuda, Krishnaprasad Kudlu Indian Journal of Ophthalmology 2019 67(8):1295-1296