Pattern of amblyopia and fixation after keratoplasty

Forty cases of clear corneal grafts in 2 groups of patients who developed corneal opacities either before or after 5 years of age were investigated for the pattern of amblyopia and fixation. A severe irreversible form of amblyopia with eccentric fixation was observed in cases of unilateral corneal opacity when the anomaly occurred before the age of 5 years and corneal grafting was delayed until the second or third decade of life. If the opacity was bilateral, although the onset was before the age of 5 years, the improvement in visual acuity after corneal grafting occurred in the relatively better eye with foveal fixation. Good visual results were seen after corneal grafting when the offending opacity occurred after the age of 5 years. Foveal fixation was also observed in most of these cases. None of the patients who had a squint preoperatively lost their angle of strabismus. Four cases in group B, however, developed an alternating squint postoperatively.