Purpose:To establish the efficacy and safety of ex vivo cultured autologous human conjunctival epithelial cell (hCjEC) transplantation for treatment of pterygia.Methods:Twenty-five patients with pterygia were recruited at different centers across the country. Autologous hCjEC grafts were prepared from conjunctival biopsy specimens excised from the healthy eye and cultured ex vivo on human amniotic membrane mounted on inserts using a unique mounting device. The hCjEC grafts were then transported in an in-house designed transport container for transplantation. Post-surgery, the patients were followed up on days 1, 7, 14, 30, 90, and 180 as per the approved study protocol. Clinical outcomes were assessed by slit lamp examination, visual acuity, imprint cytology, fluorescein/rose bengal staining, Schirmer's test, and photographic evaluation three and 6 months post-transplantation.Results:Two patients were lost to follow-up and final analysis included 23 cases. No recurrence of pterygium was observed in 18 (78.3%) patients; all of these eyes showed a smooth conjunctival surface without epithelial defects. Recurrence was observed in 5 (21.7%) patients at 3 months post-treatment. No conjunctival inflammation, secondary infections or other complications were reported. Adequate goblet cells were present in 19 (82.6%) patients at the site of transplantation.Conclusion:We have, for the 1st time, standardized a protocol for preparing autologous hCjEC grafts that can be safely transported to multiple centers across the country for transplantation. The clinical outcome was satisfactory for treating pterygia.

We are reporting a case of torpedo maculopathy (TM) over a long term follow up with the aid of multimodal imaging of Optical coherence tomography (OCT), Fundus Autofluorescence, En Face OCT, and recent OCT angiography (OCTA) findings. An asymptomatic 18 years old female was clinically found to be having a whitish spindle shaped lesion in the right eye with classic findings of TM. OCT imaging at baseline and at 2 and 4 years follow up did not reveal any change in the retinal structures. A focal excavation of the choroid along with a small subretinal cleft was also seen. Fundus autofluorescence imaging exhibits a central hypofluorescence along with a hyperfluorescent border corresponding to the lesion. OCTA segmentation of the choriocapillaris vasculature showed increased density of the choroidal vasculature suggestive of its role in the pathogenesis of this lesion. Enigma behind the pathogenesis of this rare lesion is still unsolved. Recently introduced imaging techniques can help us understand this lesion and its pathogenesis in detail.

A 20-year-old male with Marfans syndrome complained of gradual progressive diminution of vision in the right eye (RE) for 6 months. A slit-lamp examination revealed bilateral inferior lenticular coloboma with cataractous changes involving the visual axis in RE. The patient underwent phacoemulsification with a foldable intraocular lens and capsular tension ring implantation in view of zonular dehiscence in the RE. Other eye was managed conservatively.

Background: Nucleus drop during cataract surgery is a dreaded complication and requires urgent vitreo-retinal intervention which is managed commonly using a fragmatome. However, a fragmatome is not readily available in routine ophthalmology set-ups because its use is very limited. On the other hand, a phaco-probe is commonly available with all surgeons and makes it cost-effective. Purpose: The purpose is to demonstrate the utility of a phaco-probe as an alternative to a fragmatome in managing nucleus drop during cataract surgery, making it cost-effective and less time-consuming and simple. Synopsis: The video shows two cases of complicated cataract surgery in which a nucleus is dropped in the vitreous cavity. The sleeve of the phaco-probe was removed, and infusion was disconnected to make it function as a fragmatome. We noted reduced lenticular repulsion from the phaco-handpiece tip as compared to the fragmatome, and no scleral burns were observed. The cases were completed by secondary placement of an intra-ocular lens in the sulcus in the same sitting. Thus, the phaco-probe can be considered to manage nucleus drop in the absence of a fragmatome. Highlights: A phaco-probe can be used as an alternative to a framgamtome, which is a cost-effective and simple technique. Video link: https://youtu.be/6c-40Bcijrc

Familial adenomatous polyposis (FAP) is an autosomal dominant condition caused by a mutation in APC tumor suppressor gene (chromosome 5q21). Affected patients have nearly 100 percent progression to colorectal cancer. Solitary congenital hypertrophy of retinal pigment epithelium (CHRPE) and its multi focal variant, congenital grouped pigmentation (bear tracks), are isolated ophthalmic entities and are not associated with FAP and Gardner syndrome. Patients found to have solitary or multifocal CHRPE on ophthalmoscopy can be counselled that they do not have an increased risk of colon cancer compared with that of the general population.