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An exhaustive search of the world's literature was performed to analyze all case reports and series on the modified osteo-odonto-keratoprosthesis (MOOKP) published up to January 2022. The demographic profile, the primary indication for surgery, surgical technique variations, postoperative medical management, long-term functional and anatomical outcomes, and intra- and postoperative complications were analyzed and compared. Additionally, some of the authors' (GI, VP, and GA) unpublished MOOKP cases were studied. An extensive literature search yielded 37 case series and case reports. Overall, 958 patients were analyzed. The most common indication for surgery was autoimmune disease (39.1%), closely followed by chemical injury (38.8%). The most common intraoperative complications (21.67%) included maxillofacial, vitreous hemorrhage/vitritis, and mucosal. The most common postoperative complications (78.4%) were lamina and oral mucosa-associated, secondary glaucoma, and choroid/retinal detachment. Follow-up periods ranged from one to 364 months (median: 36.7 months). Altogether, 78% of patients achieved a visual acuity of 20/400 or better at the end of the follow-up period, and 91.2% improved at least temporarily after MOOKP surgery. Mean anatomic success at the end-of-follow-up for all patients was 88.25% (range, 50-100%). The long-term anatomic and functional success of the MOOKP makes it a reliable option for visual rehabilitation in patients with bilateral corneal blindness and end-stage ocular surface disease. This review aims to describe the evolution of the MOOKP procedure, analyzing all published case series for its long-term reliability, visual and anatomical outcomes, complications, and future directions.

Background/Objectives: To analyse the higher-order aberrations (HOAs) and their visual impact on a paediatric blepharokeratoconjunctivitis (PBKC) cohort compared with healthy controls. Subjects/Methods: A prospective observational, case-control study of paediatric patients (≤ 16 years old) was designed. Subjects underwent a visual system wavefront aberrometry analysis to compare HOAs and their impact on visual quality. Results 150 eyes from 76 patients were included for analysis. The PBKC group consisted of 50 eyes, and the control group included 100 healthy eyes. Mean age was 10.39 ± 3.81 years for the PBKC group and 10.80 ± 3.61 years for the controls. Mean corrected-distance visual acuity (CDVA) was 0.24 ± 0.21 LogMAR in the PBKC group and 0.07 ± 0.1 in the controls (p =

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 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

Prostaglandin analogs (PGAs) are first-line treatments for ocular hypertension (OHT) and open-angle glaucoma (OAG). However, frequent side effects and high costs hinder patient's compliance resulting in disease progression. Evidence suggests selective laser trabeculoplasty (SLT) may be considered a first-line treatment for OHT and OAG due to its safety profile, minor side effects, and reduced costs. Considering that PGAs and SLT share action mechanisms, it is hypothesized that previous PGA therapy may affect subsequent SLT efficacy. Therefore, we analyzed if PGAs reduce SLT efficacy.An evidence-based review was performed to assess the safety and efficacy of SLT in patients previously treated with PGAs. For this purpose, we performed an extensive literature search using the National Library of Medicine's PubMed and Google Scholar database for all English language articles published until May 2021.There is evidence of non-superiority of PGAs therapy versus SLT for OHT and OAG. A multicenter, randomized, observer-masked clinical trial (RCT) of untreated OHT and OAG patients concluded that SLT should be offered as the first-line treatment for these patients. This study was supported by a meta-analysis of RCTs, comparing SLT efficacy versus antiglaucoma drugs only, with the advantage of an SLT lower rate of adverse effects.Cost-effectiveness, patient compliance, and antiglaucoma drugs' side effects, including higher surgical failure, favor consideration of SLT as first-line therapy for OAG and OHT. Furthermore, SLT efficacy does not seem to be affected by prior PGA administration; however, larger cohort, comparative, multicenter RCTs are necessary to answer this question.

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 by specular microscopy the central region of the corneal endothelium. In a 4-year period, a total of 75 eyes from 42 patients were studied. All eyes included were from patients 65 or older (mean: 73.87±6.86), without ocular disease or surgeries.Results: The mean cell density (MCD) was 2268±597.0 cells/mm2. 44% of patients had polymegethism, with an average coefficient of variation (CV) of 42.04 ± 10.1%. 76% of patients had low pleomorphism, with an average of 42.3 ± 8.9% hexagonal cells. The mean corneal thickness was 537±38.2 μm. There was no statistically significant difference between age groups for MCD, CV, hexagonality and pachymetry (p=>.05). 27% of patients had corneal 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, low polymegethism and good pleomorphism.

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( 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 (

Background We report the case and management of a patient that started with primary cornea guttata symptoms after cataract surgery with trifocal intraocular lens (IOL) implant. The unusual postoperative presentation of the disease in association with a trifocal IOL resulted in increased corneal surface aberrations that resulted in visual dissatisfaction. Case presentation A 67 year-old male was evaluated due to blurred vision for two months, as well as a desire to stop using glasses in his everyday life. At the initial refraction, myopia, corneal astigmatism and nuclear cataract were diagnosed in both eyes. A nuclear cataract was diagnosed in both eyes. Phacoemulsification surgery was performed in OS, implanting a trifocal IOL. The postoperative refraction in OS was -1.25DCx120º, with a best-corrected visual acuity (BCVA) of 20/20. Six months later, the patient kept complaining of blurred vision and night glare. In slit lamp examination, corneal guttae were denoted and changes in corneal endothelium morphology suggested primary cornea guttata. A monofocal IOL exchange was performed in order to reduce corneal aberrations with excellent outcome at 2-year follow up. Conclusions Screening for endothelial dysfunction is a key element for successful outcomes in cataract surgery. Corneal guttae accent optical aberrations when in combination with premium IOLs.