Resumen El objetivo de este artículo es identificar la relación existente entre el derecho tributario y la economía pública. Siguiendo el método deductivo, con paradigma hermenéutico y con enfoque cualitativo. Los precursores modernos del derecho fiscal y de la economía pública son Petty, los cameralistas y Smith, cuyas aportaciones de principios tributarios se ven reflejados en la fracción IV del artículo 31 de la Carta Magna, soporte y columna vertebral del sistema impositivo mexicano. La interpretación jurídica tributaria es uno de los temas más polémicos en la actualidad, aquí se analiza el vínculo indisoluble entre la capacidad contributiva y económica. En los últimos años, las cortes de justicia nacionales latinoamericanas están favoreciendo el principio de capacidad económica, caso que sucedió en México con la Suprema Corte de Justicia de la Nación, donde ha señalado que en última instancia se busca favorecer el ingreso público y la redistribución del ingreso nacional.

Abstract This article aims to identify the relationship between tax law and public economics. Following the deductive method, with hermeneutic paradigm and qualitative approach. The modern precursors of tax law and public economy are Petty, the Cameralists, and Smith, whose contributions of tax principles are reflected in section IV of article 31 of the Magna Carta, support and backbone of the Mexican tax system. The legal interpretation of taxation is one of the most controversial issues today, and the indissoluble link between tax and economic capacity is analyzed here. In recent years, the national courts of justice in Latin America have been favoring the principle of economic capacity, as has happened in Mexico with the Supreme Court of Justice of the Nation, where it has pointed out that the ultimate goal is to favor public income and the redistribution of national income.

RESUMEN La investigación tuvo como objetivo principal determinar la importancia del principio de capacidad contributiva en el régimen jurídico tributario nacional, para que contribuya a evitar la afectación al patrimonio de los sujetos pasivos, y a la par la proliferación de figuras elusivas y evasoras ante el excesivo para de los tributos. Con la Constitución del 2008, el sistema tributario se rige por principios que sientan las bases para la creación, modificación y extinción de tributos los cuales están establecidos en el artículo 300. En el cual, si bien, no se encuentra el principio de capacidad contributiva de forma expresa, se encuentra inmerso en los principios tributarios de equidad y progresividad. Es por ello, que el legislador determinará la capacidad contributiva del sujeto pasivo. La presente investigación aplica el enfoque metodológico cualitativo y métodos como analítico-sintético, el histórico lógico y el inductivo-deductivo.

ABSTRACT The main objective of the research was to determine the importance of the principle of contributive capacity in the national legal tax system, in order to contribute to avoid the affectation to the patrimony of the taxpayers, and at the same time the proliferation of elusive and evasive figures in the face of the excessive taxation. With the 2008 Constitution, the tax system is governed by principles that set the basis for the creation, modification and extinction of taxes, which are established in Article 300, in which, although the principle of contributive capacity is not expressly included, it is immersed in the tax principles of equity and progressiveness. Therefore, the legislator will determine the taxpayer's taxpaying capacity. This research applies the qualitative methodological approach and methods such as analytical-synthetic, historical-logical and inductive-deductive.

RESUMO OBJETIVO Caracterizar os recursos de isenção fiscal usufruídos no Programa de Apoio ao Desenvolvimento Institucional do Sistema Único de Saúde (Proadi-SUS) nos triênios 2009–2011, 2012–2014, 2015–2017, considerando o volume total dos recursos atrelado ao debate dos gastos tributários em saúde e a constituição de uma “nova modalidade de filantropia” no setor. MÉTODOS Para compreender o setor filantrópico, analisaram-se os gastos tributários no período de 2001 e 2017. Para avaliar os recursos utilizados no programa, foram examinados os valores dos projetos e das áreas de atuação. RESULTADOS Foi constatado um crescimento real dos valores dos gastos tributários gerais e dos gastos tributários referentes ao setor filantrópico. Constatou-se, também, um aumento real dos recursos do programa. Foram realizados 407 projetos, totalizando um valor de R$ 3,4 bilhões para o período. Ao se analisar o valor médio dos projetos, explicita-se ampliação dos valores para todos os hospitais inseridos no programa, com exceção de uma das instituições. Nos triênios 2009–2011 e 2012–2014, a área de atuação com maior número de projetos e mais recursos foi a “Área de técnicas e operação de gestão em serviços de saúde”. Já no triênio 2015–2017, o setor que contou com mais investimentos e maior número de projetos desenvolvidos foi o de “Capacitação de recursos humanos”. CONCLUSÃO O programa caracteriza outro patamar na relação do setor público com o setor privado/empresariado da saúde, atrelado aos princípios da nova gestão pública. Faz-se necessária, como desdobramento para futuras investigações, uma caracterização qualitativa dos projetos desenvolvidos e do impacto das ações diante das demandas do setor público.

ABSTRACT OBJECTIVE To characterize the tax exemption resources used in the Support Program for Institutional Development of the Unified Health System (Proadi-SUS) in the 3-year periods 2009–2011, 2012–2014, 2015–2017, considering the total volume of resources linked to the debate on tax expenditures on health and the constitution of a “new form of philanthropy” in the sector. METHODS To understand the philanthropic sector, tax expenditures between 2001 and 2017 were analyzed. To evaluate the resources used in the program, the values of projects and areas of activity were examined. RESULTS A real increase in the values of general tax expenses and tax expenses referring to the philanthropic sector was found. There was also a real increase in the program’s resources. A total of 407 projects were carried out, amounting to R$ 3.4 billion for the period. An analysis of the average value of the projects shows an increase in values for all hospitals included in the program, with the exception of one of the institutions. In the 2009–2011 and 2012–2014 periods, the area with the highest number of projects and the most resources was “Management techniques and operation in health services”. In the 3-year period 2015-2017, however, the sector that received the most investments and the largest number of projects developed was “Human Resources Training”. CONCLUSION The program characterizes a different expression of the public-private partnership in the health sector linked to the principles of the new public management. As a development for future investigations, a qualitative characterization of the projects developed and the actions’ impact on the public sector demands is necessary.

ABSTRACT OBJECTIVE To characterize the tax exemption resources used in the Support Program for Institutional Development of the Unified Health System (Proadi-SUS) in the 3-year periods 2009–2011, 2012–2014, 2015–2017, considering the total volume of resources linked to the debate on tax expenditures on health and the constitution of a “new form of philanthropy” in the sector. METHODS To understand the philanthropic sector, tax expenditures between 2001 and 2017 were analyzed. To evaluate the resources used in the program, the values of projects and areas of activity were examined. RESULTS A real increase in the values of general tax expenses and tax expenses referring to the philanthropic sector was found. There was also a real increase in the program’s resources. A total of 407 projects were carried out, amounting to R$ 3.4 billion for the period. An analysis of the average value of the projects shows an increase in values for all hospitals included in the program, with the exception of one of the institutions. In the 2009–2011 and 2012–2014 periods, the area with the highest number of projects and the most resources was “Management techniques and operation in health services”. In the 3-year period 2015-2017, however, the sector that received the most investments and the largest number of projects developed was “Human Resources Training”. CONCLUSION The program characterizes a different expression of the public-private partnership in the health sector linked to the principles of the new public management. As a development for future investigations, a qualitative characterization of the projects developed and the actions’ impact on the public sector demands is necessary. ProadiSUS Proadi SUS (Proadi-SUS 3year year 3 20092011 2009 2011 20122014 2012 2014 20152017 2015 2015–2017 philanthropy 200 201 analyzed examined found programs s 40 out R 34 4 3. institutions 2009–201 2012–201 Management services. services . services” 20152017, 2017, 2015-2017 however Human Training. Training Training” publicprivate private management investigations actions necessary 2009201 2012201 2015201 2015–201 20 2009–20 2012–20 2015-201 200920 201220 201520 2015–20 2 2009–2 2012–2 2015-20 20092 20122 20152 2015–2 2009– 2012– 2015-2 2015– 2015-

RESUMO OBJETIVO Caracterizar os recursos de isenção fiscal usufruídos no Programa de Apoio ao Desenvolvimento Institucional do Sistema Único de Saúde (Proadi-SUS) nos triênios 2009–2011, 2012–2014, 2015–2017, considerando o volume total dos recursos atrelado ao debate dos gastos tributários em saúde e a constituição de uma “nova modalidade de filantropia” no setor. MÉTODOS Para compreender o setor filantrópico, analisaram-se os gastos tributários no período de 2001 e 2017. Para avaliar os recursos utilizados no programa, foram examinados os valores dos projetos e das áreas de atuação. RESULTADOS Foi constatado um crescimento real dos valores dos gastos tributários gerais e dos gastos tributários referentes ao setor filantrópico. Constatou-se, também, um aumento real dos recursos do programa. Foram realizados 407 projetos, totalizando um valor de R$ 3,4 bilhões para o período. Ao se analisar o valor médio dos projetos, explicita-se ampliação dos valores para todos os hospitais inseridos no programa, com exceção de uma das instituições. Nos triênios 2009–2011 e 2012–2014, a área de atuação com maior número de projetos e mais recursos foi a “Área de técnicas e operação de gestão em serviços de saúde”. Já no triênio 2015–2017, o setor que contou com mais investimentos e maior número de projetos desenvolvidos foi o de “Capacitação de recursos humanos”. CONCLUSÃO O programa caracteriza outro patamar na relação do setor público com o setor privado/empresariado da saúde, atrelado aos princípios da nova gestão pública. Faz-se necessária, como desdobramento para futuras investigações, uma caracterização qualitativa dos projetos desenvolvidos e do impacto das ações diante das demandas do setor público. ProadiSUS Proadi SUS (Proadi-SUS 20092011 2009 2011 20122014 2012 2014 2012–2014 20152017 2015 2017 2015–2017 filantropia filantrópico analisaramse analisaram 200 Constatouse, Constatouse Constatou se, Constatou-se também 40 R 34 3 4 3, explicitase explicita instituições 2009–201 Área saúde. . saúde” Capacitação humanos. humanos humanos” privadoempresariado privado empresariado pública Fazse Faz necessária investigações 2009201 201 2012201 2012–201 2015201 2015–201 20 2009–20 200920 201220 2012–20 201520 2015–20 2 2009–2 20092 20122 2012–2 20152 2015–2 2009– 2012– 2015–

Resumen La recolección de residuos sólidos es una típica competencia municipal que se da por la prestación del servicio público y aunque pareciera no presentar particularidad, es posible repensarla a partir de los principios basados en la economía circular. A razón de lo mencionado, la presente investigación tiene como objetivo analizar cuál es la situación actual de las tasas de recolección de residuos en el Ecuador, a la luz del principio quien contamina paga; toda vez que la Constitución de la República establece derechos al buen vivir, agua y medio ambiente sano como bienes jurídicos protegidos que los gobiernos municipales, a través de sus competencias constitucionales, pueden efectivizar en las tasas de recolección, incorporando elementos tributarios de carácter ambiental, permitiendo así aportar a los Objetivos de Desarrollo Sostenible.

Abstract Solid waste collection is a typical municipal competence that occurs due to the provision of public service and, although it does not seem to present any particularity, it is possible to rethink it based on the principles of the circular economy. In view of the aforementioned, the purpose of this investigation is to analyze the current situation of waste collection rates in Ecuador, in light of the polluter pays principle; since the Constitution of the Republic establishes rights to good living, water, a healthy environment as protected legal assets, which municipal governments and their constitutional powers, can make effective through collection rates, incorporating environmental tax elements, thus contributing to the Sustainable Development Goals.

Abstract This article seeks to highlight the current problems of the Colombian tax system in perspective of legal security and tax law; for this the principle of justice is based as a natural orientation of the Tax Law, the principles that frame the legality and the legal security for the configuration of the tax law, analyzing the jurisprudence to end with the presentation of the Colombian case, its excessive normative production, the constant tax reforms and the disparity for tax effects generated by the current accounting regulation framework, highlighting the arduous task that the country must undertake to correct these legal defects and achieve a more equitable and fair tax legal system.

Resumen El presente artículo busca evidenciar la problemática actual del sistema tributario colombiano en perspectiva de la seguridad jurídica y la ley tributaria; para ello se parte del principio de justicia como una orientación natural del derecho tributario, los principios que enmarcan la legalidad y la seguridad jurídica para la configuración de la ley tributaria, analizando la jurisprudencia para finalizar con la exposición del caso colombiano su excesiva producción normativa, las reformas tributarias constantes y la disparidad a efectos tributarios generada por el marco de regulación contable vigente, dejando en evidencia la ardua tarea que debe emprender el país para corregir estos defectos jurídicos y lograr un sistema jurídico tributario más equitativo y justo.

ABSTRACT: The paper is based on three key considerations: first, that tax conflicts are becoming more usual and that their non-resolution leads to undesirable consequences; secondly, that traditional mechanisms are not enough to avoid and solve them and, thirdly, that the principle of unavailability of tax credit is one of the main legal obstacles for applying alternative mechanisms. According to this, the purpose of this paper is to determine the possibility for applying alternative mechanisms of conflict prevention and resolution in the tax field and analyze their specific inclusion in the Argentine national tax law. Conclusions indicate that the principle of unavailability of tax credit does not impede the application of alternative mechanisms for tax disputes, although certain conditions must be respected, and that Argentine national tax law has been incorporating some alternative mechanisms, but many of them have not been implemented for the moment.

RESUMEN: El trabajo parte de tres consideraciones clave: en primer lugar, que los conflictos tributarios son cada vez más habituales, y que su falta de resolución acarrea indeseables consecuencias; en segundo lugar, que los mecanismos tradicionales no son suficientes para evitarlos y solucionarlos, y, en tercer lugar, que el principio de indisponibilidad del crédito fiscal constituye uno de los principales obstáculos jurídicos para aplicar los mecanismos alternativos. A partir de ello, el objetivo consiste en determinar la posibilidad de aplicar los métodos alternativos de prevención y resolución de conflictos en el ámbito tributario y analizar su inclusión específica en el derecho tributario nacional argentino. En las conclusiones se advierte que el principio de indisponibilidad del crédito fiscal no impide la aplicación de los métodos alternativos para conflictos tributarios, aunque deben respetarse ciertas condiciones, y que el derecho tributario nacional argentino ha ido incorporando algunos mecanismos alternativos, pero muchos de ellos todavía no se han implementado.

Resumo A maior parte dos Princípios Jurídicos variam no tempo e no espaço, influenciados significativamente pelos valores sociais de uma determinada sociedade em determinado tempo. É precisamente o que ocorre com o Princípio da Igualdade, cujo conteúdo, inicialmente voltado para uma aplicação constante da lei para todos, em muitas jurisdições foi transformando-se em um Princípio a exigir do Estado condutas positivas aptas a promover uma igualdade de oportunidades para os administrados. Em matéria tributária, o Princípio da Igualdade exige que a carga tributária seja suportada de forma justa entre os contribuintes, o que implica que diferenciações, positivas ou negativas, não podem ser meramente arbitrárias, mas sim fundadas em necessariamente em motivações constitucionais. Observar o Princípio da Igualdade, em matéria tributária, pode auxiliar na construção de sistemas tributários por vezes mais simples e sempre mais justos. Contudo, enquanto recomendável a observância do Princípio da Igualdade, nem sempre é fácil estabelecer critérios de comparabilidade e igualdade entre os contribuintes, uma vez que dificilmente dois contribuintes são idênticos. Embora desafiador, é possível estabelecer algumas premissas que podem nos auxiliar a traçar parâmetros de comparabilidade entre contribuintes e verificar se as diferenciações realizadas atendem ao Princípio da Igualdade. É precisamente este o objeto de nosso estudo: traçar algumas premissas que nos permitam identificar, em casos concretos, se as discriminações tributárias atendem ao Princípio da Igualdade. Para tanto, aplicaremos nosso “teste de igualdade” a um caso concreto: a tributação de microempreendedores individuais (MEI).

Abstract Most Legal Principle varies in time and space, influenced by social values of a given society at a given time. It is precisely what happens with the Principle of Equality. While at first, equality solely demanded the law to be applied uniformly in all cases, it later became, in many jurisdictions, a guideline to Governments, demanding the promotion of equal opportunities to all citizens. When it comes to taxation, the Principle of Equality requires the tax burden to be divided fairly among taxpayers, what implies that differences, whether imposing a higher or lower taxation, may never be made on arbitrary basis but rather on Constitutional grounds. Taking the Principle of Equality seriously can assist in building simpler and more fair tax systems. It is not always easy to observe the Principle of Equality on taxation, as it may be difficult to stablish comparability criteria and framing taxpayers as equals, once taxpayers are hardly equal. While difficult, it is possible to establish a few premises that can assist on the task of comparing taxpayers and understanding if the differences on the law are compliant with the Principle of Equality. This is precisely the purpose of our article: drawing a few premises that can help us understand in concrete cases if the discriminations promoted by the legislation are compliant with the Principle of Equality. After drawing such premises, we will try applying our “equality test” to a concrete case: the microentrepreneurs taxation regime.

Abstract: This article seeks to demonstrate the legal instability of income tax in Colombia, its negative effect on legality and equity of the tax system and the consequent inequitable distribution of tax burdens. It deals in a general way with the evolution of income tax from 1918 to 2018, it describes the current structure for both natural and legal persons, it analyses some relevant legal aspects arising from the application of the tax framework from the perspective of tax benefits and the fiscal cost according to the reports submitted by UAE DIAN in 2004 to 2018, warning how tax spending has fragmented the principles of tax justice in Colombia, imbuing not only taxation but the tax system a whole with an halo of injustice.

Resumen: Este artículo busca evidenciar la inestabilidad jurídica del impuesto de renta en Colombia, su efecto negativo en la confianza, la legalidad y la equidad del sistema tributario, y la consecuente inequitativa distribución de la carga tributaria. Para ello aborda de manera general la evolución del impuesto desde 1918 a 2018, describe la estructura actual, tanto para las personas naturales como las jurídicas, analiza aspectos jurídicos relevantes derivados de la aplicación del marco tributario en perspectiva de los beneficios tributarios y el costo fiscal según el análisis de los informes presentados por la UAE DIAN entre 2004 y 2018, advirtiendo cómo el gasto tributario ha fragmentado los principios de justicia tributaria en Colombia, impregnando de un halo de injusticia no solo a la imposición, sino al sistema tributario en conjunto.

ABSTRACT: In this work I will discuss about the concretion of the principle of tax equity. Its purpose is being an academic contribution in order to consolidate the legal doctrine of tax equity. Specifically, I will analyze different conceptions of inequality and its treatment in tax matters; also, I will explore cases of violations of this principle. To achieve the purpose, I analyze Comparative Law; specifically, jurisprudence of the Spanish Constitutional Court. The conclusions are consequences of a rational reconstruction of those decisions by using the logic model of normative systems of Alchourrón y Bulygin.

RESUMEN: En este trabajo se discute respecto de la concreción del principio de igualdad tributaria. Su propósito es ser una contribución académica para la consolidación de la dogmática jurídica del principio de igualdad en materia tributaria. Específicamente, se analizan diferentes criterios que permitan establecer cuándo una desigualdad de trato en materia tributaria puede ser considerada arbitraria y, por tanto, una vulneración de este principio. Para lograr este propósito se analiza el Derecho Comparado; específicamente, la jurisprudencia del Tribunal Constitucional español. El resultado de este trabajo se presenta elaborando una reconstrucción racional de estas sentencias, utilizando el modelo lógico de los sistemas normativos de Alchourrón y Bulygin.

Resumo O presente artigo pretende demonstrar que a partir do segundo mandato de Lula (2007-2010), após o país ter conquistado a estabilidade fiscal, e devido à crise de 2008, a orientação da política fiscal e tributária se voltou para a competitividade internacional e o desenvolvimento do país. Lula passou a adotar políticas monetárias e fiscais "anticíclicas", a fim de recuperar o nível de atividade econômica o mais rápido possível. Essa virada foi feita por alterações e introdução de novos instrumentos extrafiscais da tributação, principalmente através de isenções fiscais e de redução de tributos sem, contudo, romper com os princípios do paradigma anterior, centrado na estabilização econômica e fiscal. Assim, tais mudanças foram feitas com modificações por meio de instrumentos tributários extrafiscais seguindo um processo de sedimentação institucional.

Abstract This article argues that from the second term of Lula (2007-2010), after the country achieved fiscal stability and due to the 2008 crisis, the orientation of fiscal and tax policy turns to international competitiveness and development of the country. Lula adopts "'countercyclical'" fiscal and monetary policies in order to recover the level of economic activity as quickly as possible. This change was made by modifications and introduction of new extrafiscal instruments of taxation, mainly through tax exemptions and tax reductions without, however, breaking with the principles of the previous paradigm, centered on economic and fiscal stabilization. Thus, such changes were made through modifications in the extrafiscal instruments of taxation following a process of institutional sedimentation.

In order to verify the possibilities of building a legal doctrine about the material tax principles or tax justice principles in the Chilean Legal System, considering Comparative Law, this paper analyzes the development of the same in the Spanish Legal System, in the context of constitutional duty to contribute to public expenses. The category is reviewed as well as the principles of generality, equality, progressiveness, non-confiscation and economic capacity to pay. They are enclosed in the principle of tax fairness. The concretion of the latter requires the dogmatic development of all the material principles of taxation, as a whole and not individually, given the deep interrelation between them. Nevertheless, there are some experts who defend the existence of an autonomous principle of tax justice. The article emphasizes the complexities to consider in the analysis presented of every principle mentioned, and definitely they are transferred to the constitutional goal to create a fair tax system.

A fin de verificar las posibilidades de construir una dogmática jurídica relativa a los principios tributarios de carácter material o de justicia tributaria en Chile, considerando el Derecho Comparado, en este artículo se analiza el desarrollo de los mismos en el Derecho español, en el contexto del deber constitucional a contribuir a los gastos públicos. Se revisa dicha categoría, como asimismo los principios de generalidad, igualdad, progresividad, no confiscatoriedad y capacidad económica. Todos ellos se comprenden en el principio de justicia tributaria. La concreción de este último exige el desarrollo dogmático de todos los principios materiales de la tributación, en conjunto y no solo individualmente, dada la profunda interrelación existente entre ellos. No obstante ello, hay algunos especialistas que defienden la existencia de un principio de justicia tributaria autónomo. El artículo enfatiza las complejidades a considerar que se presentan dentro del análisis de cada principio mencionado, y que, en definitiva, se traspasan al objetivo constitucional de crear un sistema tributario justo.

The current economic crisis has highlighted various issues and causes changes of all kinds. Among the issues that are affecting are the basilar fundaments of Spanish tax law: the constitutional principles of taxation. This is not so much due to a crisis. Rather it is that its application and interpretation chaired by the flexibility since its enactment in 1978, brings different challenges to the effectiveness front the tax system problems whose seriousness, at this time, has increased. The tension between the seriousness of these difficulties and the effectiveness of the principles opens the debate on whether to keep reinforcing them, change their meaning or dispensed with whenever the current reality does not match that agreed at the time of its approval.

La actual crisis económica ha puesto en evidencia diferentes problemas y es causa de cambios de todo tipo. Entre las cuestiones a las que está afectando se encuentran los fundamentos basilares del Derecho tributario español: los principios constitucionales tributarios. No es tanto que su pérdida de vigor sea una novedad debida a la crisis. Más bien se trata de que su aplicación e interpretación presididas por la flexibilidad desde su promulgación en 1978pongan en dificultades su efectividad ante diversos problemas del sistema tributario cuya gravedad, en el presente momento de convulsión económica, se ha acentuado. La tensión entre la seriedad de esas dificultades y la vigencia de los principios abre el debate sobre la conveniencia de mantenerlos reforzándolos, cambiar su significado o prescindir de ellos, toda vez que la realidad actual no se corresponde con la que coincidió en el momento de su aprobación.

Background: Many countries have conducted studies on the benefits of phototherapeutic keratectomy in corneal diseases; few references have been found in our country to address the results of the application of the excimer laser in the elderly suffering from bullous keratopathy. Objective: To assess the results of the application of phototherapeutic keratectomy in the eldrly with bullous keratopathy. Methods: A case series study was conducted in 2009, in the Cornea Department of the Dr. Gustavo Aldereguía Lima General University Hospital of Cienfuegos. It included 16 elderly with bullous keratopathy not leading to penetrating keratoplasty. After considering the ethical and biomedical assessment, phototherapeutic keratectomy was performed. Treatment was indicated and follow up was performed with an assessment of symptoms and signs until the third month. Results: In the postoperative stage symptoms decreased and the most frequent sign was the haze followed by slight increase in best corrected visual acuity. Conclusions: The application of phototherapeutic keratectomy in patients that did not apply for cornea transplant helps improving eye condition, reduces symptoms and improves visual acuity.

Fundamento: en muchos países se han realizado estudios sobre los beneficios de la queratectomía fototerapéutica en las afecciones corneales; se han encontrado escasas referencias en nuestro país que aborden los resultados de la aplicación del láser de excímeros en los adultos mayores aquejados de queratopatía bullosa. Objetivo: valorar los resultados de la aplicación de la queratectomía fototerapéutica en adultos mayores con queratopatía bullosa. Métodos: estudio de serie de casos realizado durante el año 2009, en el Departamento de Córnea del Hospital General Universitario Dr. Gustavo Aldereguía Lima de Cienfuegos, que incluyó 16 adultos mayores con queratopatía bullosa no tributaria a queratoplastia penetrante. Después de tener en cuenta los principios éticos y una evaluación biomédica, se les realizó la queratectomía fototerapéutica. Se indicó tratamiento y se llevó a cabo el seguimiento con una valoración de síntomas y signos hasta el tercer mes. Resultados: en el posoperatorio la sintomatología disminuyó y el signo más frecuente fue el haze (38 %) seguido de las alteraciones visuales (25 %) y del leve incremento en la agudeza visual mejor corregida. Conclusiones: la aplicación de queratectomía fototerapéutica en pacientes no tributarios a trasplante de córnea contribuye a mejorar el estado ocular, disminuye los síntomas y mejora la agudeza visual