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Emergency keratoplasty is indicated in corneal lacerations involving the visual axis in children subject to amblyopia and in adults with avulsion of the cornea. Such injuries usually involve the lens and vitreous, requiring scleral expansion, lensectomy, vitrectomy, and intraocular exploration. After culture and institution of antibiotics, definitive surgery should be delayed until a donor graft and specialized personnel are available. Postoperative occlusion of the uninjured eye in children must be continued until age 6–7 to prevent amblyopia.