Introduction

Abstract

In 1831, the possibility of a successful corneal transplantation was considered as ‘certainly one of the most audacious fantasies, and it would be the highest reward of surgery if this operation succeeded’ (Dieffenbach 1831). One hundred twenty five years later, Thomas reported that ‘it was universally accepted that the results of keratoplasty are good’ (Thomas 1955). At that time the level of clear grafts was around 50% (Stansbury 1949, Owens et al. 1949, Ciotola 1949, Roberts 1950, Lohlein 1950). In 1980, Bloomfield reported that ‘corneal transplantation enjoys a high success rate because the avascularity of the cornea and the absence of lymphatic drainage in this areabestow a considerably degree of immunological privilege’. That hypothesis had been presented as early as 1965 by Nelken. Sanfilippo (1982) classified penetrating keratoplasty as ‘a routine and somewhat benign procedure’. In just over 150 years, a most audacious fantasy has been transformed into a routine procedure.

‘The clinical importance of corneal grafting lies in the fact that successful transplantation can restore excellent sight to persons suffering from corneal blindness’ (Jones 1973).