[Results of optic reconstructive interventions in children with ocular injuries]

Optic reconstructive interventions were carried out in 36 children with ocular injuries aged 3-14 years. Perforating keratoplasty was combined with measures aimed at repair of the normal anatomic status of the eye and the transparency of its optic media. Microsurgical interventions were performed for penetrating corneal wounds in 27 cases, for penetrating corneoscleral injuries in 8, and for eye contusion in 1 case. The patients were followed up for 1 year after surgery. Taking in of donor cornea, time course of visual acuity, intra- and postoperative complications, and the risk factors of the graft failure were evaluated. Transparent healing of donor cornea was observed after 1 month in 94% cases and after 1 year in 60%. In the immediate postoperative period, vision improved in 32 patients, deteriorated in 1, and did not change in 3 patients. In 56% children visual acuity with correction of 0.05 diopters and higher was attained, while before the intervention the predominant (in 80% children) variant was pr. certae. Among the complications, the most incident were graft rejection crises and secondary glaucoma liable to conservative therapy. Vitreoretinal injury is one of the unfavorable factors fraught with the graft failure. Hence, perforating keratoplasty is an effective and obligatory surgical procedure ensuring sufficient visual rehabilitation in the majority of children with severe ocular injuries.