The younger the childrenChild are at the time of corneal transplantationCorneal transplantation, the worse the survival prognosis of the graft. However amblyopiaAmblyopia will become worse while waiting too long. This constellation presents an everlasting dilemma between corneal surgeons and pediatric ophthalmologists. Preoperative considerations are significant in terms of accurate parental education, ensuring adherence to therapyTherapy, choosing the appropriate surgical time frame (amblyopiaAmblyopia versus graft failureGraft failure, compliance of the patient). Parental education must include the reduced visual prognosis in young childrenChild, exceptions being later acquired corneal pathologies such as inflammatory corneal scars (herpes) and keratoconusKeratoconus. A distinction must be made between morphological care after transplantationTransplantation and refractive correction as well as amblyopiaAmblyopia therapyTherapy. The younger the childrenChild, the less favourable the prognosis for the transplant and the more often multiple anaesthetic examinations are necessary in order to detect complicationsComplications such as infiltrates or suture loosening at an early stage. Especially unilateral congenitalCongenital pathologies often do not lead to a sufficient improvement of amblyopiaAmblyopia (refractory amblyopiaAmblyopia, poor compliance due to very dominant healthy eyeEye). The prognosis after keratoplastyKeratoplasty in childhood is already partly decided by the careful indicationIndication (no surgery of a sclerocornea) and the detailed and realistic information of the parents (cooperation with ocular and systemic treatmentTreatment even if the childChild has poor compliance, frequent check-ups, reduced chances of amblyopiaAmblyopia therapyTherapy). The younger the childChild at the time of transplantationTransplantation, the more frequent graft failureGraft failure and the development of complicationsComplications. Later manifesting diseases in older childrenChild (herpetic corneal scars, keratoconusKeratoconus) have a better prognosis.