Purpose To evaluate a region of interest (ROI) method of analyzing anterior segment optical coherence tomography (AS-OCT) corneal densitometry (CD) in the setting of Descemet membrane endothelial keratoplasty (DMEK) dehiscence. Methods Retrospective chart review of eyes that underwent (1) DMEK for Fuchs dystrophy (2) between 2018 to 2020 with (3) a partial DMEK dehiscence on AS-OCT, (4) involvement of only one side of the graft, (5) high-quality corneal AS-OCT scan, and (6) location of dehiscence within the central 5.5 mm of the cornea. Image analysis of the ROIs with ImageJ compared the total edematous area, mean stromal CD, and ratio of anterior-to-posterior (A/P) stromal CD for regions of DMEK dehiscence compared to the contralateral side with an attached DMEK graft. Control regions (with no dehiscence) and postdehiscence resolution images were also analyzed. Results Seventy sectors of the 21 images from 21 eyes with DMEK dehiscence were included. Compared to the contralateral side, regions of DMEK dehiscence had larger total areas ( P < 0.0001), lower mean stromal CD ( P = 0.0003), and higher A/P stromal CD ( P < 0.0001). All control regions and postdehiscence resolution images did not show any significant differences compared to the contralateral sides. Conclusions This technique to analyze multiple ROIs on AS-OCT can be useful to evaluate CD of specific regions of corneal pathology. Lower mean stromal CD and higher A/P stromal CD may specify corneal edema. Translational Relevance Analyzing CD via multiple specific ROIs may be more suitable than measuring the CD of the full cornea and has broader applications extending to other corneal pathologies.

The uninsured Hispanic pediatric population in the United States faces significant challenges in accessing medical care due to language barriers, citizenship status, and limited access to health insurance. Clínica Comunitaria Esperanza Pediátrica (CCE-P) is a bilingual student-run free clinic created to provide healthcare to the underserved population in southeastern Virginia. This study further details the creation, implementation, and early outcomes of CCE-P as well as barriers encountered throughout the process. It describes four critical steps in establishing CCE-P, including leveraging existing institutional partnerships, ensuring high standards of care, prioritizing community outreach, and implementing a quality improvement program. Study outcomes include a demographic characterization of the 46 pediatric patients served by CCE-P, a description of clinic services, and an analysis of gaps in care and strategies to provide more comprehensive health services. This publication serves as an outline to an adaptable model that other organizations may use to establish similar clinics in their own communities.