Establecer una comparación entre la técnica PRK convencional, asistida con alcohol (PRKaa), y la trans-PRK de un solo paso, en cuanto a variables clínico-refractivas y quirúrgicas. Método: Se realizó un estudio observacional, prospectivo, longitudinal, en 72 pacientes candidatos a cirugía refractiva corneal con excímer láser, con el diagnóstico de astigmatismo miópico compuesto, en el Centro Oftalmológico Exiláser, Cuenca, Ecuador, de septiembre a diciembre de 2019. Los pacientes fueron intervenidos por técnicas de superficie (trans-PRK o PRKaa). El procesamiento de los datos se realizó en el programa SPSS, versión 21.0. Para la comparación de los datos de ambas técnicas quirúrgicas se empleó la prueba de chi cuadrado, donde se consideró p < 0.05 estadísticamente significativo. Resultados: Se obtuvo como equivalente esférico promedio para PRKaa −0.14 y para trans-PRK −0.11, a los 3 meses del procedimiento (p = 0.34). El promedio de agudeza visual sin corrección obtenido fue en PRKaa de 0.93 y en trans-PRK de 0.96, sin diferencias estadísticamente significativas (p = 0.63). El tiempo quirúrgico para PRKaa fue de 1,080.85 s y para trans-PRK fue de 720.31 s, menor en esta última con diferencia estadísticamente significativa (p < 0.001). En trans-PRK hubo menor dolor inmediatamente después de la cirugía, comparado con PRKaa (p < 0.05). El día promedio de cierre epitelial en PRKaa fue el 6.27 y en trans-PRK el 3.62 (p = 0.02). conclusiones: La PRK-transepitelial de un solo paso y la PRKaa realizada en pacientes candidatos a cirugía refractiva producen resultados muy similares a los 3 meses de la cirugía en cuanto a AVSC, equivalente esférico obtenido y mínimas complicaciones postoperatorias. La trans-PRK ofrece mayores ventajas al paciente, referentes a menor tiempo quirúrgico, rápido cierre epitelial y menor dolor en el postoperatorio inmediato.

Objective: To compare conventional alcohol-assisted PRK (aaPRK) and single-step transPRK in terms of clinical-refractive and surgical variables. Method: An observational, prospective, longitudinal study was carried out in 72 patients who were candidates for corneal refractive surgery with the excimer laser, with a diagnosis of compound myopic astigmatism, at the Exilaser Ophthalmological Center, Cuenca, Ecuador, from September to December 2019. Patients underwent surface surgery (transPRK or aaPRK). Data processing was performed with the SPSS program, version 21.0. For data comparison between both surgical techniques, the chi-square test was used, where P < 0.05 was considered statistically significant. Results: The average spherical equivalent was obtained for aaPRK (−0.14) and transPRK (−0.11) 3 months after the procedure (p = 0.34). UCVA average was 0.93 in aaPRK and 0.96 in transPRK, without statistically significant differences (p = 0.63). Surgical time was shorter in transPRK (720.31 s) compared to aaPRK (1080.85 s), with a statistically significant difference (p < 0.001). In transPRK there was less pain immediately after surgery, compared to aaPRK (p <0.05). Epithelial closure was achieved on day 6.27 for aaPRK and in day 3.62 for transPRK (average values; p = 0.02). Conclusions: Single-step transepithelial PRK and aaPRK in patients who are candidates for refractive surgery showed very similar results 3 months after surgery in terms of uncorrected visual acuity, spherical equivalent and with minimal postoperative complications. TransPRK offers greater advantages to the patient regarding shorter surgical time, rapid epithelial closure and less pain in the immediate postoperative period.

Objective: To describe the preliminary results of the use of Intense Regulated Pulsed Light (IRPL) in patients with Dry Eye Syndrome due to Meibomian Gland Dysfunction (MGD). Methods: A descriptive, longitudinal and prospective study was performed in 32 patients diagnosed with Dry Eye Syndrome, in which treatment with IRPL was applied between April-December 2017 at the Ophthalmological Center Exilaser, in Cuenca, Ecuador. Three treatment sessions were performed on Day 0, Day 15 and Day 45. Absolute and relative frequencies, Pearson test and Fischer test were used for statistical analyses. Results: After treatment with IRPL, tear film breakup time (BUT) greater than 10 seconds was observed in 87.5% of the patients, with a correlation between treatment application and a BUT greater than 10 seconds. There was a decrease in the signs observed in the eyelid margin; this decrease was more evident in blepharitis cases. In 81.3% of the cases, a gentle pressure was enough when performing the gland expression, to obtain a clear liquid in 62.5% of the cases. All the OSDI test items showed improvement. Conclusions: Our results show an improvement of the clinical signs and symptoms of Dry Eye Syndrome due to MGD after a course of three IRPL sessions over a 45-day period. However, more IRPL studies with a longer follow-up are warranted.

Objetivo: Describir los hallazgos clínicos y tomográficos de un caso con toxoplasmosis ocular atípica. Caso clínico: Varón de 32 años que inició con disminución de la agudeza visual en el ojo izquierdo, con edema papilar y vítreo transparente, sin estrella macular. Presencia de IgM positiva para toxoplasmosis. Se muestran resultados de laboratorio, tomografía de coherencia óptica papilar y características de las fibras del nervio óptico. Una vez iniciado el tratamiento por toxoplasma, se obtuvo una mejoría clínica significativa, verificada con imágenes del fondo de ojo. Conclusiones: El edema papilar por toxoplasmosis con vítreo transparente es poco frecuente en la práctica. Sin embargo, es un cuadro que debe tenerse en cuenta en el diagnóstico diferencial como una presentación atípica de la toxoplasmosis ocular.

Purpose:The aim of the study was to describe the clinical and tomographic findings of a case with atypical ocular toxoplasmosis. Observations: This is the case of a 32-year-old patient who presented with decreased visual acuity in the left eye, papillary edema, and transparent vitreous without a macular star positive IgM test for toxoplasmosis. Laboratory test results, papillary OCT, and the characteristics of optic nerve fibers are shown. After Toxoplasma gondii was treated, significant clinical improvement was seen in the patient that was confirmed on the images of the eye fundus. Conclusions: Papillary edema due to toxoplasmosis with clean vitreous is not a common finding in the routine clinical practice. However, it should be taken into account while performing differential diagnosis as an atypical presentation of ocular toxoplasmosis.