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Purpose: To assess the corneal endothelial morphometry in healthy elderly Hispanic eyes. Methods: A retrospective, cross-sectional, observational, descriptive, and analytical study was designed to assess the central region of the corneal endothelium by specular microscopy. A total of 241 eyes from 125 patients were studied. All eyes included were from healthy patients 65 or older (mean: 74.56± 6.74), without ocular disease or surgeries. Results: The mean cell density (MCD) was 2198.92±493.43 cells/mm2. 125 (51.87%) eyes had polymegethism, with a mean coefficient of variation (CV) of 42.89 ± 9.16%. 148 (61.41%) eyes presented pleomorphism, with an average of 46.25 ± 7.13% hexagonal cells. The mean corneal thickness was 527.55±28.37 μm. A statistically significant difference between age groups was found for MCD and pachymetry (P<0.05). 41 eyes (17.01%) had cornea guttata. Conclusion: This study suggests that the elderly Hispanic population has a high prevalence of polymegethism, pleomorphism, and guttata. Surprisingly, the oldest age group (>85) had an above-average MCD, with lower rates of polymegethism and pleomorphism. Trial Registration Number: #ARCC/ECH2019 Date of Registration: October 18, 2019

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Objective:The objective of this study was to report the early results of CyberKnife ® (CK ® ) stereotactic radiosurgery in advanced stages of ciliochoroidal (CBCh) melanoma in Mexican patients. Methods: A retrospective review of charts was performed to analyze the outcomes of patients who underwent CK ® (Accuray Inc, Sunnyvale, CA, United States). Results: Four patients with CBCh melanoma were treated under this protocol. The mean age was 53.2 ± 5.3 years (range, 47-60). Median of follow-up was 9.5 ± 3.1 months (range, 5-12). Mean tumor diameter was 13.49 mm, mean thickness, 11.74 mm, and mean gross tumor volume was 1251.97 mm 3 . Tumors were dome-(50%) and mushroom-shaped (50%) in medium-to-large sizes. Three patients had T3b tumors, and one had a T4d tumor at the early tumor staging according to the American Joint Committee on Cancer. A mean dose of 2763 ± 181.3 cGy was prescribed to the 90% isodose line. All patients achieved local tumor control after single-session radiosurgery at the latest follow-up. One patient presented with acute toxicity (extensive serous retinal detachment associated with radiation induced tumor vasculopathy) that was promptly managed. None of the patients required secondary enucleation. Conclusions: CK ® appears to be an effective therapy for medium to large-sized CBCh melanoma. A prospective comparative study with longer follow-up is needed to confirm these findings and to evaluate long-term morbidity.

Purpose: The aim was to report on the visual outcomes and safety of myopic LASIK performed in patients with corneas of central thickness below average(<540μm) and normal topography. Methods: This is a retrospective cohort study conducted at a private practice setting on Mexican Hispanic patients who underwent myopic LASIK between January 2014 and January 2015. An analysis of records of patients >18 years-old with previous normal topography, stable refraction, corrected visual acuity ≥ 20/20 (Snellen), Central Corneal Thickness (CCT) < 540μm and at least 12 months follow up after surgery was conducted. The main outcome measures were standard visual outcomes (efficacy, safety, refractive stability) and Percent Tissue Altered (PTA) analysis was conducted. Results: A total of 51 patients (102 eyes) were included; 56% (n=57) were female. The mean age was 26.52 ± 8.06 (range 18-55 years) with a mean follow up of 13.9 ± 1.2 months. Preoperative CCT was 515.44 ± 17.87μm (range 452- 540μm), with a mean refractive spherical equivalent (SEQ): -4.08 ± 2.17 D (range -0.75 to -9.75 D), and mean refractive cylinder: -1.44 ± 1.29 D (range 0.00 to -6.00 D). Mean predictability of postoperative SEQ was -0.20 ± 0.40 D (range -1.25 to +1.25). Postoperative SEQ was ±0.50 D in 71%, ±1.00 D in 93% of the eyes. Postoperative uncorrected distance visual acuity was ≥20/20 in 78% and ≥20/25 in 95%. One line of CDVA was lost in 3% of the eyes, no eyes lost ≥2 lines. No ectasia cases were observed during follow-up. Conclusion: LASIK surgery in Mexican Hispanic patients with thinner than “normal” corneas (<540 μm) is safe, efficient and predictable at 1 year follow up for myopic refractive corrections with no evidence of postoperative keratectasia.

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Reportar el caso de queratitis de inicio tardío de origen fúngico 2 meses después de una queratoplastia penetrante (QPP). Caso: A un paciente de sexo masculino, de 24 años, se le realizó una QPP en el ojo izquierdo por queratocono avanzado, sin complicaciones. A los 2 meses presenta infiltrados corneales, y se inicia tratamiento empírico. El infiltrado progresó y se realizaron dos cultivos y una biopsia corneal, con resultados negativos. En una segunda biopsia corneal se evidenció Candida glabrata. Se logró un tratamiento exitoso con anfotericina B tópica, intracamerular e intraestromal. La neovascularización del injerto corneal se trató con anti factor de crecimiento endotelial vascular intraestromal y subconjuntival. Se realizó una segunda QPP en conjunto con cirugía de catarata secundaria. A los 2 años, el paciente tiene una agudeza visual corregida para distancia de 20/20 en el ojo tratado. Conclusión: La biopsia corneal y la terapia agresiva son claves en el tratamiento de casos de queratitis refractarias después de una QPP.