Ophthalmologist consultation has an important role in the examination of pregnant women. In some cases, his conclusion can play a decisive role in choice of delivery method. Obstetricians-gynecologists rely on ophthalmologist opinion for determining the severity of preeclampsia; it affects the treatment tactics and the life of mother and child. Examination of a pregnant woman has a number of characteristics, with regard to them, 3 groups of patients, which can be identified: the first group — Physiological pregnancy
without ophthalmological pathology. The second group: Physiological pregnancy with eye pathology in the anamnesis: myopia, peripheral choriovitreoretinal dystrophy; retinal detachment, vitreous body, vascular membrane, etc. Third group — Pathologically flowing pregnancy with pathology resulting from pregnancy: pre-eclampsia, anemia, diabetes and others pregnant. In physiological pregnancy without ophthalmological pathology, the most common physiological changes are increased pigmentation around the eyes, ptosis, a decrease of conjunctival capillaries, changes of cornea sensitivity and thickness, and, consequently, a change in refraction with a myopic shift, a decrease of tolerance to contact lenses, a decrease intraocular pressure, hemeralopia. It is necessary to differentiate the physiological feature of pregnancy, which include, in particular, the shift of refraction to the myopia, from pathological manifestations such as retinal angiopathy, macular edema, central serous chorioretinopathy and others. An important aspect is the  identification of potentially dangerous conditions of laser retina coagulation no later than 34 weeks of gestation with considering the
possibility of rheumatogenic retinal detachment and dystrophic changes in the delivery. This procedure can allow avoiding operative
delivery in the second group of patients. Timely detection of angiospasm on fundus in patients with pre-eclampsia from the third group, will make the right choice in the tactics of managing a pregnant woman. Carrying out the minimum instillation medication regime, especially in the first trimester of pregnancy, will make it possible to reduce the negative impact of therapy on the mother and child

To study the world literature (monographs and periodicals) regarding the frequency of anisometropia, its role in amblyopia development and prevalence of anisometropic amblyopia, its clinical and morphofunctional features, to reveal new aspects of etiology and pathogenesis.We have performed a literature review of Russian and foreign monographs and periodicals, internet resources. The paper presents statistical data regarding the wide prevalence of anisometropia (which manifests by asymmetry in the fellow eye and doesn’t reduce it, and anisometropia that leads to amblyopia), its classification and describes the alterations in the human organism that accompany anisometropia. It is shown that along with the sensory disorders which are peculiar to the other types of amblyopia, in anisometropic amblyopia we observe morphofunctional alterations that are special enough and differentiate anisometropic amblyopia from its other types. The paper describes the peculiarities of the retina and choroid in anisometropic amblyopia, revealed by means of optical coherence tomography and determining its specificity. Anisometropia is widely spread among children and adults. As a possible reason for visual acuity reduction, it is found in 1.0–2.3% of cases according to the different investigation data (the difference in refraction of both eyes of more than 1.5 D may become the reason
for amblyopia). Anisometropia of less than 1.5 D, i.e. one that does not lead to visual acuity reduction, is found almost in 50% of cases among unselected population. Therefore, further investigation of anisometropic amblyopia pathogenesis as well as of accompanying sensory, morphological and functional alterations is of great importance

Purpose. The analysis of clinical effectiveness of a triplex transplant in recovery of extensive through eyelid defects. Patients and  methods. 18 patients were under observation (18 eyes) aged from 27 to 68 years with extensive through eyelid defects. The area of
defects varied from 69 to 105 mm2 (average 87.5 ± 9.0 mm2). The reasons of through eyelid defects were: a mechanical trauma —
5 patients, an explosive trauma — 2 patients, result of surgery of tumors a century — 11 patients. All patients were divided into
2 groups. The main group consisted of 9 people (9 eyes) who had triplex transplant containing a temporal muscle for replacement of
through eyelid defects. The control group consisted of 9 people (9 eyes) who had a double-layer tissular transplant for replacement of
through eyelid defects. Besides basic ophthalmologic examination, the research of speed and intensity of recovery of local  hemodynamic of transplant was conducted to all patients. The examination was made in 3, 10 days, 1 month after operation, then once in 6 months. Results. In 1 month after operation in main group reparative process came to the end with formation of a gentle thin hem on border of skin transplant. Color of skin transplant was identical to nearby tissues. Secondary cicatricial deformations of skin transplant were absent. Only in 5 patients of control group in 1 month after operation process came to the end with formation of thin hem on border of transplant. 3–6 months later rough deformations of transplant was not observed in any patients of the main group. Cicatricial shortening of the operated eyelid with formation of partial coloboma and eversion of eyelid were in 3 patients of control group that demanded carrying out the second stage of surgical treatment. Conclusion. The offered method of blepharoplasty with use of a temporal muscle makes a practical contribution in development of the perspective direction of a reconstructive plastic surgery of extensive through eyelid defects.

Purpose. To evaluate laser retinotomy efficacy in the retinal detachment (RD) due horseshoe tear prevention. Patients and methods. 57 eyes of 54 patients with subclinical retinal detachment due to the peripheral horseshoe retinal tear were enrolled. 26 eyes of 25 patients of main group undergone combined laser technology included a barrier retinal photocoagulation of the local detachment zone, accompanied with deffered Nd:YAG laser retinotomy. The barrier retinal photocoagulation alone was performed on 31 eyes of 29 patients in control group to compare postoperation results. The assessment of the peripheral vitreoretinal interface was carried out by fundus ultrasound scanning, multispectral scanning laser imaging and spectral optical coherence tomography. The efficacy of the laser treatment was estimated by local retinal detachment height and area changes, while the safety was estimated by intra- and post-op complications rate. All patients were examined at the baseline, 1 week, 1, 3, 6 and 12 month follow-up. Results. Both main and control groups undergone barrier laser photocoagulation with complete round demarcation of subclinical local retinal detachment. All twenty five patients of main group achieved successful laser resection of retinal horseshore flap without any evidence of clinically significant complications. YAG-laser retinotomy in patients with retinal horseshoe tear resulted in decreased values of local retinal detachment height and area (in 40 and 38% respectively, p < 0.05). At the 12-month follow-up full retinal adhesion has been achieved in 15 eyes (58%), while partial adhesion has been observed in 7 eyes (27%). Obtained data were significantly lower compared with control group where some sings of retinal detachment progression were appeared (in 11 and 4% respectively, p > 0.05). No evidence of clinically significant complications after laser treatment has been
revealed. Conclusions. The obtained data have demonstrated the efficacy and the safety of laser retinotomy in traction component reducing and consequent risk of retinal detachment minimising.

Purpose: To assess the topographic location of the demarcation line in in different areas of the cornea after standard corneal crosslinking.
Patients and methods. 12 patients (15 eyes) with keratoconus of stages 1–2 of Amsler-Kruimerich classification were observed. UV cross-linking was performed in all patients according to the standard Dresden protocol with 0.1% aqueous solution of riboflavin. The patients underwent optical coherence tomography of the anterior segment of the eye on “DRI OCT Triton” (“Topcon”, Japan) in different areas of the cornea to assess the location of the demarcation line. Results. Demarcation line was revealed in
1 month after standard corneal cross-linking in most cases (87%). Biomicroscopy showed that DL limited the anterior and middle
laers of the stroma from the posterior one. The stromal demarcation line depth according to OCT averaged 305.73 ± 41.08 μm (range of 282–345 μm) at the center, nasally — 215.16 ± 35.5 μm (range of 160–289 μm) and temporally 205,23 ± 32.81 μm (range of 190–276 μm). A significant difference in the depth of DL localization in the central zone of the cornea and a 6 mm zone (p < 0.001) was noted. Conclusion. The corneal stromal (обычно) demarcation line is one of the indicators of the depth of photochemical process of corneal cross-linking. Optimal timing of detection of DL following corneal collagen crosslinking is 2 weeks — 3 months. The depth of DL in the corneal studied areas is different; it is deeper in the central zone than in the peripheral ones.

Purpose: to investigate the cornea condition in the patients after anterior radial keratotomy in long-term (over 20 years) period.
Patients and methods. The study involved 80 patients (147 eyes) aged from 41 to 65 years, who had keratotomy in average 23.9 ± 1.9 years ago. The number of keratotomy scars varied from 6 to 18. Radial keratotomy was performed in 125 eyes, in 22 eyes — radial and tangential keratotomy, repeat radial keratotomy about residual moderate myopia was performed in 3 eyes. Ophthalmologic examination of patients included conventional techniques. Results. In 76.2% of cases in the corneal optical zone were observed accumulation of hemosiderin; in 63.3% — signs of intraoperative micro- and macroperforations, going through all cornea layers, capturing the Descemet membrane and the endothelium, leading to a decrease in the density of endothelial cells. There was subepithelial fibrosis in 2.7% cases; the signs of postkeratotomic keratectasia with expressed refractive disorders and prevalence of hyperopic complex or mixed forms of astigmatism were in 9.5%; during the endothelial microscopy in 21.8% of cases «dark zones» were revealed. It in combination with pleomorphism and polimegatizm indicates a decrease of endothelial functional reserve in patients after anterior radial keratotomy. Conclusions. The special features of the cornea state oafter keratotomy in the long term are including the accumulation of hemosiderin in the corneal optical zone, the signs of intraoperative perforation in the area of keratotomy scars, subepithelial fibrosis, postkeratotomy keratectasia, reducing of the density of endothelial cells, pleomorphism, polimegatizm, «dark zones» found at endothelial microscopy

Purpose: to evaluate on experimental model electron-microscopic changes of rabbit retina after staining of the posterior eye segment
with combined dyes based on Trypan blue and Brilliant blue G for the assessment of their safety. Methods. The study was performed on
Chinchilla breed rabbits. Combined dyes based on Trypan blue and Brilliant blue were used: MembraneBlue-Dual (DORC, Netherlands)
and “Staining solution for ophthalmic surgery” (JCS “Optimedservis”, Russia). Standard three-port vitrectomy technique was used. After vitreous removal dyes were injected in vitreous cavity and exposed for 10 seconds and then removed. The vitreous cavity was filled by a balanced salt solution. An electron-microscopic evaluation was performed on 5, 14 and 30 days after surgery. Eyes were enucleated in 20 minutes after animal was killed by air embolization. Intact eyes were used as a control, all samples were prepared in same сonditions. The damage of the retina architectonics and the presence of intracellular inclusions were evaluated. Results. The staged character of pathomorphological changes was revealed. On the 5th day moderate edema and hydropic dystrophy of neurons were registered. On the 14th day, there was no negative dynamics. On day 30, the signs of edema and dystrophy of neurons practically disappeared, which may indicate a fundamental reversibility of the registered changes. Conclusion. Investigated dyes for staining intraocular structures based on Trypan blue and Brilliant blue did not cause significant histomorphological changes and toxic effects on retinal cell structures. Detected electron microscopic changes were insignificant, had reversible character and could be mostly caused by a surgical injury.

Introduction. Ocular surface diseases related with limbal epithelial stem cells dysfunction were united in term “limbal stem cell  deficiency” (LSCD). For experimental study of the regenerative processes and evaluation of the success of new LSCD treating
methods LSCD model is required. Various LSCD models were proposed in the experiment to study: mechanical, thermal, chemical,
medicamental. The main lack of these models were the relative high cost and complexity of execution. The mechanical model allows for
the guaranteed removal of tissues containing LESCs, and therefore seems to be the most acceptable. We offered a modification of the
mechanical LSCD model in rabbits. Purpose to create a standardized modification of the mechanical limbal stem cell deficiency model
in the experiment. Material and methods. The experimental study was performed in 10 mature Chinchilla rabbits (20 eyes) with an
average weight 2.5–3.5 kg. With the local anesthesia, after a 40-second application of the filter paper impregnated with 20% ethanol,
the corneal epithelium was removed. With microsurgical diamond blade we metered limb portion of 4 mm width, 0.2 mm deep, and
it was removed along the 360° rim. Results. On the 30th day we discovered corneal opacity and neovascularization with conjunctival
pannus extending to the optical zone of the cornea. Histological examination revealed tissue edema, inflammatory infiltration, and
newly formed vessels. In some places, thinning of epithelium to one row of flattened cells was observed. The Bowman membrane was
deformed and practically not detected. Histological examination and impression cytology confirmed the presence of goblet cells in the
corneal epithelium. Conclusions. Our modification of the mechanical limbal stem cell deficiency model is devoid of the main lacks of
previous models, such as the high cost and complexity of execution, provides intraoperative limbal tissue resection depth control and
excludes the possibility of the eye perforation. It is effective, universal, standardized and available for widespread use.

Purpose: comparison of some ophthalmobiometric parameters in natural and cycloplegic conditions in myopia and hypermetropia.
Material and methods: eyes biometric parameters were examined (the depth of the anterior chamber, the lens thickness and AL)
before and after cycloplegia (1% Cyclopentolate hydrochloride — 2 times) in 244 eyes with myopic and hyperopic refraction in 122
patients aged 5–32 years. Biometric parameters were examined on the Galilei G6 optical system analyzer (Ziemer Ophthalmic Systems
AG 6.0.6). The thickness of the choroid was measured with a spectral optical coherent tomograph (SD-OCT wavelength 800 nm) of Nidek RS-3000 Retina Scan Advance in 20 eyes of 10 patients aged 11 ± 1.3 years from the examined group before and 40 minutes after double injection of 1% Cyclopentolate hydrochloride. Results: the depth of anterior chamber and the axial, both in the narrow pupil and under the cycloplegia, are significantly higher in the myopic eyes than in the hyperopic eyes (p < 0.05 for ACD and p < 0.01 for AL), and the lens thickness is practically does not differ. In absolute terms, the position of irido-lens diaphragm, i.e. distance from the posterior surface of the cornea to the center of the lens in myopia group was significantly higher than with hyperopia respectively, of 5.62 ± 0.02 mm of 5.29 ± 0.01 mm (p < 0.01). However, the coefficient Lowе ((ACD + 1/2LT)/AL) in myopia was significantly lower (of 0.219 ± 0.001 and 0,238 ± 0,001, respectively) is due to the greater of the AL. After cycloplegia, in both myopic and hyperopic eyes, DAC increases: in myopia, on average, 0.12 mm, with hyperopia — by 0.14 mm, and accordingly the thickness of the lens decreases. The coefficient Lowe in both cases is increased by 0,04 mm. Interesting changes were observed in the length of AL: under conditions of cycloplegia, it decreased by 0.03 mm (30 microns) in eyes with myopia (p > 0.05) and by 40 microns (0.04 mm) with hyperopia (p < 0.01). Conclusion: In cyclopegic condidions, as compared to the existing accommodation, increasing the depth of the anterior chamber decreased the thickness of the lens center of the lens somewhat extended posteriorly and decreases the axial length. The revealed changes in the AL can be associated with a change in the position of the pigment epithelium layer due to changes in the thickness of the choroid under different accommodation conditions. The significant changes in the thickness of the choroid the influence of cycloplegia was not proved in this study.

Purpose. To study hemodynamic of optic nerve (ON) in process of complex pathogenetic direct treatment in patients with anterior
ischemic optic neuropathy (AION). Patients and methods. 43 patients with acute phase AION were exanimated and treated. Besides the functional results (visual acuity, visual field), the diagnosis AION was based on indicators of ophthalmologic and angiographic researches of ON. Patients were divided into two groups. 23 patients were in the main group. They received neurometabolic medicinal preparations (MP) through a silicone retrobulbar catheter. The control group consisted of 20 patients who had the traditional method of medicines injection. Indexes of hemodynamic were estimated according to Doppler ultrasound of local blood flow at the short posterior ciliary arteries (SPCA). At the same time following indexes were estimated: Peak Systolic Velocity (PSV, cm/sec), End Diastolic Velocity (EDV, cm/sec), Average Blood Velocity (ABV, cm/sec), Index of peripheral vascular resistance (R1, M ± m). Results. After the end of hospitalization of patients with AION, more favorable shifts in indexes of hemodynamic in SPCA were reached in patients of main group of research that authentically exceeded the similar data obtained at patients in the control group. Improvement of blood flow of ON was followed by positive changes of thickness of the retinal nerve fiber layer and condition of disk ON. To the final stage of researches (12 months from beginning of treatment) according to degrees of functional disorders severity in the main group of patients prevailed I (14 patients, 60%), less often II degrees (9 patients, 40%) of optic nerve atrophy and absented patients with III degrees of defeat of ON. Among patients of control group II–III degree optic nerve atrophy (12 patients, 60%) met more often, less often I degrees (8 patients, 40%). Conclusion. The conducted research showed that at patients with AION receiving sub-Tenon's infusions of MP more significant favorable functional results were reached thanks to increase of indicators of blood flow in SPCA: PSV — on 24.5%, EDV — on 16.2%, ABV — on 32.2% that significantly exceeds similar data at patients in control group with traditional methods of MP injections.

Article retracted.

Рurpose. А meta-analysis of randomized clinical trials of efficiency and safety of retinalamin water-soluble polypeptide retinal fractions
complex neuroprotective therapy in patients with dry age-related macular degeneration (amd), conducted in russia. Мethods. Published results of various clinical trials were searched by a single investigator using the “scientific electronic library” (elibrary.ru). meta-analysis included all clinical trials of retinalamin efficacy, where its route of administration and dosage corresponded with the guidelines for medical use of retinalamin in patients with dry amd. Results. Primary search revealed 320 publications concerning retinalamin. 11 of those presented results of randomized clinical trial that satisfied the requirements, and hence were included into the meta-analysis. beside the parabulbar and intramuscular administration, prescribed officially, retinalamin was also administered subconjunctivally, with electrophoresis and with subcutaneous injections in temporal zone. in three studies the observation period is 3 months, in one study it is 5 months, in four studies it is 6 months, and in two studies it is 12 months. in the rest of studies the observation period is less than 3 months. all the studies present the changes in visual acuity right after the therapy course. meta-analysis revealed a statistically significant visual acuity improvement, best discernible in patients with areds 3 amd stage up to 6 months after retinalamin treatment. the positive dynamics in visual acuity changing persists during the first 3 months. repeated
therapy courses in 3–6 months provided further progress. perimetry revealed the increasing of visual field borders and decreasing
of central scotomae amount and area; the findings have also improved after the repeated course. the electrophysiology studying
showed the positive dynamics as well and correlated with visual acuity changes. optical coherence tomography, blood flow examination and a series of other tests were also used. however, varying diagnostic methods in different trials as well as a low level of statistical data processing, impeded the fulfillment of a comprehensive analysis. Conclusion. Randomized clinical trial meta-analysis proved the efficacy of retinalamin therapy in patients with dry amd

Purpose. To study the clinical effectiveness of the system of complex treatment of optic neuritis (ON) associated with herpesvirus infection
(HVI), including methods of immunopharmacotherapy. Patients and methods. The clinical study involved 55 people (55 eyes) with acute
ON associated with HVI. The treatment regimen for all patients included 10 days the addition of Dexamethasone solution to optic nerve on decreasing scheme, Emoxypine 1% 0.5 ml, and Dicynone 12.5% 0.5 ml through irrigation system implanted in retrobulbar space, in combination with appoint of neuroprotective drugs (Picamilon and Semax). Depending on features of immunotherapy, all patients were divided into 3 groups. The first group consisted of 20 patients, whose treatment in addition to the above included intravenously infusions 6 mg of Polyoxidonium from the moment they entered the eye hospital. The second group included 17 patients who received in addition to Polyoxidonium, muscle injections of Cycloferon, in mode and doses according to the manufacturer's instructions. The third group of patients (18 peoples) — with using etiotropic immunotherapy that consisted of combination of Polyoxidonium, Cycloferon and endonasal electrophoresis of 0.25% solution of Derinat. The duration of immunotherapy was 10–12 days. Results. The analysis of obtained datas showed that more significant positive dynamics was noted in the clinical course of ON in patients of the 3rd group of observation, who simultaneously received complex of 3 immunotropic drugs in comparison with group 1 and 2, in the treatment of which we used one immunotropic drug Polyoxidonium, or its combination with Cycloferon, without Derinat. Conclusions. The method of etiotropic and pathogenetic immunotherapy developed by us, represented by the combination of Polyoxidonium, Cycloferon and Derinat, at ON, associated with herpesvirus infection, allows to shorten by 2 times or more the period of stopping of signs of inflammation in optic nerve, to exceed the average visual acuity in the period of clinical recovery by 0.5–1.3 times and improve functional results of treatment in the absence of recurrence of the disease within 1 year of observation

Refractive errors in children is one of the most important problems of ophthalmology. Over the past decades, the trend of increasing
the number of children with myopia and accommodation disorders continues to persist in the world. The present study was organized
to update data on the prevalence of refractive errors among schoolchildren in Moscow. The studied group included school-age
children: pupils of 1, 5, 11 classes. The inclusion criteria were: myopia — refraction above –0.5 D, hypermetropia — refraction above +0.5 D, astigmatism above 0.5 D. The results of survey 1557 pupils from Moscow schools, the proportion of patients with refractive errors was 24–28%, while the proportion of patients with myopia among 1st class pupils was only 2%. In 5th class, the rate was 10%, in the 11th grade reached 23%, i.e. increased more than 10 times. Noteworthy is the fact that since the 5th class, there were differences in the prevalence of myopia in groups of boys and girls. It is significantly higher in girls. This can be explained by the fact that girls spend more time for learning process and with a faster growth rate of girls in these age periods. This pattern was also revealed in the 11th class, which undoubtedly indicates adverse visual influence of the training loads. The obtained data on the prevalence of refractive errors, including myopia, in children and adolescents, can be used as the basis for planning the measures of improving preventive eye care for children and young people

Purpose. To evaluate the prevalence, clinical severity, clinical and pathogenetic variants and etiology of dry eye (DE) in patients
before refractive surgery. Methods. OSDI testing, lipid interferential test, TBUT, Shirmer-1, -2 tests, compression Norn test in Korb
modification, calculation of xerosis index by Bijsterveld, tear meniscus index evaluation, LIPCOF test, evaluation of epitheliopaty and microerosion by Tseng and lid viper epitheliopaty were performed in 600 myopia (with or without astigmatism) patients (234 men, 366 women; 30.1 ± 6.26 years old) before refractive surgery. The structure of the DE etiological conditions, was studied both in DE patients and non-DE subjects with calculation of the Pearson xi-square test. To estimate the strength of the connection between the etiological condition and the DE, the normalized value of the Pearson coefficient (C') was used. Results. The dry eye prevalence was 38.83% (of them, 71.76% was mild, 28.83% — moderate, by Brzhesky). Clinical and pathogenetic variants of mild DE included: lipid deficiency (53.29%); lipid-mucin deficiency (26.95%); mucin deficiency (11.38%); state without signs of lipid or mucin deficiency (8.38%). In patients with moderate DE were identified: isolated aqueous deficiency (6.06%); aqueous-lipid deficiency (34.85%); aqueous-mucin deficiency (7.58%); aqueous-lipid-mucin deficiency (51.52%). Statistically significant (р < 0.01) etiological conditions for the disease in patients with diagnosed DE include: contact lenses wearing (C' = 0.349); visual display use (C' = 0.342); the use of medication affecting tear production or tear film stability (C' = 0.41); application of cosmetics (cosmetic pencil or mascara) in the intercostal space of the eyelid margin — in the area of the excretory ducts of the meibomian glands (C' = 0.44); meibomian glands dysfunction (C' = 0.782); chronic allergic conjunctivitis (C' = 0.543); the presence of gynecological pathology (C' = 0.413); thyroid gland diseases (C' = 0.32); allergy (C' = 0.563); female sex (C' = 0.559). Conclusion: Raising the awareness of ophthalmologists about the prevalence of early DE manifestations in patients before refractive surgery will help optimize the detection of this pathology. The obtained data on the structure of DE clinical and pathogenetic variants and the etiological prerequisites can serve as a basis for the development of therapy. One of the most prevalence and significant etiological condition for DE was MGD, leading to lipid-deficiency, which determines the direction of etio-pathogenetic treatment — the eyelids hygiene.

The article describes the clinical cases of acute keratoconus in three patients with Down syndrome who underwent penetrating  keratoplasty. Acute keratoconus were diagnosed in patients by examination of medical history, biomicroscopy, corneal topography,
optical coherence tomography. Acute keratoconus occurs suddenly due to the rupture of Descemet’s membrane in the zone of its
stretching, when chamber moisture seeps into the thickness of the stroma, causing its swelling and perforation. If untreated, the
process continues for 3–5 months. Most researchers recommend keratoplasty during the cold period of the disease. However, with
the threat of perforation require urgent surgical intervention. There are two effective methods of surgical treatment: epikeratophakia
and penetrating keratoplasty. Patients underwent penetrating keratoplasty. The preference for this method was given in connection
with the following factors: young age patients (under 40 years), relatively healthy transparent peripheral zone of the cornea, which
was observed in our patients, genetically determined diseases — Down syndrome, the threat of corneal perforation in the centre, a
penchant for rubbing his eye, low vision other eye and the desire to obtain speedy optical effect along with the treatment. All patients
after penetrating keratoplasty had improvement of visual acuity with observation periods up to 1 year. Due to the relatively high
incidence of keratoconus in patients with Down syndrome should focus the attention of ophthalmologists. Thus, difficulties in the
diagnosis of ophthalmic pathology in patients with concomitant Down syndrome can cause errors in verification of diagnosis and hence
wrong treatment selection. In case of hydrops of the cornea penetrating keratoplasty is the choice treatment and contributes to the preservation of the eye and visual functions.