Addressing corneal opacity after herpes zoster infection.

A 15-year-old boy was referred for corneal opacity evaluation. The patient had a previous herpes zoster virus (HZV) infection-varicella-zoster virus (VZV)-with ocular manifestation 1 year ago. After the infection, he developed a central corneal scar and decreased corrected distance visual acuity (CDVA) in the right eye. The slitlamp examination showed the right eye with central corneal opacity (involving anterior stroma), lacuna area between the haze, fluorescein negative, and no vascularization near the scar (Figure 1JOURNAL/jcrs/04.03/02158034-202406000-00019/figure1/v/2024-07-10T174224Z/r/image-tiff). The patient had been treated with oral valacyclovir and topical corticosteroids without any improvement of visual acuity or changes in opacity within the 1-year follow-up. His CDVA was 20/200 (-4.50 -0.75 × 25) in the right eye and counting fingers (-4.00) in the left eye. Intraocular pressure was 12 mm Hg in both eyes. Fundoscopy was normal in the right eye, but he had a macular scar in the left eye (diagnosed when he was 7 years). The left eye had no cornea signs. The patient has no comorbidity or previous surgeries. Considering this case, a corneal central scar in a 15-year-old boy, legally single eye only, and assuming it is an opacity in the anterior stroma, would you consider surgery for this patient? If so, which would you choose: Would you consider an excimer laser treatment of his ametropia while partially removing his opacity, a phototherapeutic keratectomy (PTK), or a PTK followed by a topography-guided treatment, femtosecond laser-assisted anterior lamellar keratoplasty (FALK), or deep anterior lamellar keratoplasty (DALK) or penetrating keratoplasty (depending on the scar depth)? Would you consider prophylactic acyclovir during and after surgery? Would you consider any other surgical step to prevent delayed corneal healing-persistent epithelial defect? Before the surgical approach, would you consider treating this patient with topical losartan (a transforming growth factor [TGF]-ß signaling inhibitor)? Would you first perform the surgery (which one) and then start the medication? Furthermore, if so, how long would you treat this patient? Would you consider treatment with another medication?

Promotor de la enseñanza media en Estomatología: Dr. José Felipe López Campo / Promoter of secondary education in Stomatology: Dr. José Felipe López Campo

El profesor José Felipe López Campos es un ejemplo de formación de las nuevas generaciones. Destacado en la participación en actividades revolucionarias y sociales, la formación de recursos humanos universitarios y nivel medio en Estomatología. Profesor de varias asignaturas de pregrado y posgrado, y responsable nacional de la formación del personal para-estomatológico. Se realizó una investigación histórica para recopilar los datos biográficos más generales del Dr. José Felipe López Campo. Se consultaron como fuentes documentales el expediente de cuadros de la Facultad de Estomatología y la documentación aportada por la familia. La información fue organizada según su desempeño político, su labor docente-administrativa, su actividad científica, así como las condecoraciones que recibió. Gracias a este hombre fue sembrada la semilla del futuro árbol estomatológico en Cuba después del triunfo de la Revolución y se convirtió así en un precursor de la Docencia Médica Media y Profesional de la Estomatología.

Professor López Campo, example training new generations. Featured in revolutionary activities and participation in social, human resource training and university level over Stomatology, Professor of several undergraduate courses and graduate and as a national staff training para-stomatological. Historical research was conducted to gather more general biographical data of Dr. José Felipe Lopez Field. It was as documentary sources record box, Faculty of Stomatology and documentation provided by the family. The information was organized according to their political performance, their teaching-administrative, scientific activity and the decorations he received from others. Thanks, this man who sow the seeds of future stomatological tree in Cuba after the triumph of the Revolution, becoming a forerunner of Medical teaching and Professional Media Stomatology.