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Five patients with Down's syndrome underwent penetrating keratoplasty for keratoconus. In three patients, the indication for surgery was acute corneal hydrops, which had not resolved in the three months before surgery. The other two patients had corneal scars. Two patients had combined penetrating keratoplasty, cataract extraction, and intraocular lens insertion. Four of the five patients maintained clear grafts at their most recent follow-up examination. Two of the five patients had one or more graft reaction episodes; one graft was lost. Good results can be obtained in penetrating keratoplasty for keratoconus in patients with Down's syndrome who do not demonstrate a tendency toward excessive eye rubbing and for whom a single observant caretaker can be relied on to provide consistent postoperative care.

There are two antiviral agents that are commercially available for use in ocular herpes infections, idoxuridine, and vidarabine (Ara-A). In topical usage, these medications are similar in their effectiveness and toxicity; however, vidarabine is systemically active for treatment of deep ocular disease. Trifluorothymidine, which is still an experimental drug, has been shown in double-blind clinical trials to be the most potent antiviral drug for ocular use. These three antiviral drugs, however, are not truly selective in their action and interfere with normal cellular functions as well as virus synthesis. Several new drugs have been reported that are selective and are only effective in herpes virus infected cells; the most active of these compounds appears to be acycloguanosine.