A Brief History of Corneal Transplantation - From Ancient To Modern

4/8/2018 A brief history of corneal transplantation: From ancient to modern
Oman J Ophthalmol. 2013 Sep-Dec; 6(Suppl 1): S12–S17. PMCID: PMC3872837

doi: 10.4103/0974-620X.122289 PMID: 24391366
A brief history of corneal transplantation: From ancient to modern

Alexandra Z Crawford, Dipika V Patel, and Charles NJ McGhee
Department of Ophthalmology, New Zealand National Eye Centre, Faculty of Medical and Health Sciences, University of Auckland, Auckland,
NewZealand
Correspondence: Prof. Charles NJ McGhee, Department of Ophthalmology, Private Bag 92019, University of Auckland, Auckland, New
Zealand. E-mail: c.mcghee@auckland.ac.nz
Copyright : © 2013 Crawford AZ, et al
This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use,
distribution, and reproduction in any medium, provided the original author and source are credited.
Abstract Go to:
This review highlights many of the fundamental concepts and events in the development of corneal
transplantation – from ancient times to modern. Tales of eye, limb, and even heart transplantation appear in
ancient and medieval texts; however, in the scientific sense, the original concepts of corneal surgery date
back to the Greek physician Galen (130-200 AD). Although proposals to provide improved corneal clarity
by surgical interventions, including keratoprostheses, were better developed by the 17th and 18th centuries,
true scientific and surgical experimentation in this field did not begin until the 19th century. Indeed, the
success of contemporary corneal transplantation is largely the result of a culmination of pivotal ideas,
experimentation, and perseverance by inspired individuals over the last 200 years. Franz Reisinger
initiated experimental animal corneal transplantation in 1818, coining the term “keratoplasty”.
Subsequently, Wilhelmus Thorne created the term corneal transplant and 3 years later Samuel Bigger,
1837, reported successful corneal transplantation in a gazelle. The first recorded therapeutic corneal
xenograft on a human was reported shortly thereafter in 1838—unsurprisingly this was unsuccessful.
Further progress in corneal transplantation was significantly hindered by limited understanding of
antiseptic principles, anesthesiology, surgical technique, and immunology. There ensued an extremely
prolonged period of debate and experimentation upon the utility of animal compared to human tissue, and
lamellar versus penetrating keratoplasty. Indeed, the first successful human corneal transplant was not
performed by Eduard Zirm until 1905. Since that first successful corneal transplant, innumerable
ophthalmologists have contributed to the development and refinement of corneal transplantation aided by
the development of surgical microscopes, refined suture materials, the development of eye banks, and the
introduction of corticosteroids. Recent developments, including the replacement of selected corneal layers
rather than full-thickness keratoplasty, have the potential to improve or transform corneal transplant
surgery in the future.
Keywords: Cornea, history, keratoplasty, transplantation
Introduction Go to:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3872837/?report=printable 1/13
Contemporary corneal transplantation techniques are the result of a culmination of ideas, experimentation,
and perseverance over centuries [Table 1].[1] The evolution of transplantation can be traced from ancient
mythology, through early religious writings to the modern era. Each cell and organ-defined branch of
transplantation also has its own unique history,[2] and the chronicles of corneal transplantation weave in
and out of the main story of organ transplantation. The word “graft” is a metaphoric derivation of the
Greek graphion meaning writing implement or stylus.[3] The metaphor was established in the late 15th
century through the observation that two artificially united plant stems resembled a writing stylus. The
original sense of the word refers to the insertion of a plant part into a living plant. However, the medical
application of the word is a late 19th century development. This review article highlights some of the
pivotal events in the development of corneal transplantation.
Before Modern Times: Myth to Theory Go to:
The ancient Greeks conceived of transplantation, albeit in the form of mythical monsters woven from the
various parts of different animals. The most spectacular of these creatures was the chimaera; a fire
breathing creature composed of the body and head of a lion, a dragon's tail, and the head of a goat arising
from the center of the spine. The earliest known literary reference to the chimaera appears in Homer's
Iliad.[4] However, the term chimaera has passed into modern transplantation nomenclature to denote an
organism of diverse genetic constitution. Interestingly, the term chimaera has also come to mean a
fantastical delusion.[3]
The first description of human organ transplantation appears in ancient Chinese texts dating from the 4th
century BC. The eminent Chinese surgeon, Tsin Yue-Jin is reported to have exchanged the hearts of two
soldiers; one endowed with a strong will but a weak spirit and the other conversely afflicted. However, the
original concept of corneal transplantation is attributed to the Greek physician Galen (130-200 AD) a few
centuries later.[1] Generally considered the founder of experimental physiology, Galen proposed abrasio
cor’naea (precursor of superficial keratectomy) as a means of restoring corneal transparency. However,
there are no reports of Galen actually attempting this procedure.[5]
The patron saints of physicians and surgeons, twin brothers Cosmas and Damian are credited with
performing human transplantation in the 3rd century AD.[6] These early Christian martyrs were known as
(literally the silverless) as they practiced medicine without fee according to their beliefs. Their
most famous exploit, popularly depicted in paintings, involved the transplantation of a leg from a recently
deceased Ethiopian soldier to replace the ulcerated leg of an elderly parishioner. The divine prerogative of
transplantation continued with the account of Saint Lucy (283-304 AD); the patron saint of ophthalmology.
According to the legend, Saint Lucy plucked out her beautiful eyes in order to escape unwelcome attention
from an undesirable suitor. Her virtue was rewarded with the restoration of her sight with a pair of even
more beautiful eyes. The most famous incarnation of Saint Lucy is in Dante's Divine Comedy. Plagued
himself by poor eyesight, it is thought that Dante may have viewed Saint Lucy as his personal patron saint.
[7]
Theory to Practice Go to:
In the 17th century, the alchemy from myth to theory began with the work of the Dutch microbiologist
Antonie van Leeuwenhoek and his microscopic observations of the cornea.1 The first description of a
keratoprosthesis is attributed to the French surgeon Guillaume Pellier de Quengsy.[8] During the French
Revolution in 1789, he published the first monograph dedicated to ophthalmology. In this work, he
suggested that a transparent material could be used to replace an opaque cornea in order to restore vision.
Erasmus Darwin (Grandfather of Charles) proposed the first trephine in 1796, and postulated that the
cornea might heal by secondary intention to form a ‘transparent scar’.[9] “Could not a small piece of
cornea be cut out by a kind of trephine, about the size of a thick bristle, or a small crow quill, and would it
not heal with a transparent scar?” (Erasmus Darwin, Zoonomia, or the laws of organic life).[9]
Progress in corneal transplantation was given impetus by an epidemic of blinding Egyptian ophthalmia
(trachoma) which ravaged Europe early in the 19th century.[10] British and French soldiers engaged in the
Egyptian campaigns of the Napoleonic wars (1789-1799) contracted the disease and subsequently
introduced it into the ‘crowded tenements of Europe’ on their return from service. This disease was
responsible for the establishment of ophthalmology as the first of the surgical subspecialties and provided
the stimulus for the foundation of Moorfields Eye Hospital, London, in 1817.[10]
Experimentation in corneal transplantation did not begin until the 19th century [Table 2].[1] In 1813, Karl
Himley (1772-1837) was the first to suggest that transplanted corneas from other animals could be used to
replace opaque animal corneas.[1] However, it was his student, Franz Reisinger (1768-1855), who initiated
experimental animal corneal transplantation in 1818.[11] He coined the term keratoplasty and in 1824
suggested the use of animal tissue to replace human corneas. Reisinger performed his experiments on
hundreds of rabbits and chickens, excising the host cornea with a cataract knife and suturing the graft in
place. Unfortunately, his experiments met with failure.
A contemporary of Reisginer, Johan Dieffenbach (1792-1847), also experienced repeated failures in

replacing entire corneas in a variety of animal species. He later described the idea as ‘one of the most
audacious fantasies’ and remarked that it ‘would be the highest reward of surgery if this operation
succeeded’.[12]
In 1837, dwindling hope in the feasibility of the procedure was revived by the Irish surgeon Samuel Bigger
who published a report describing his successful attempts at keratoplasty.[13] Bigger was travelling near
Cairo in 1935 when a local war broke out and he was abducted for ransom by Bedouins.[1] During his
captivity, having his surgical instruments with him, he performed the first reported successful penetrating
allograft in animals on a pet gazelle blinded by extensive corneal scarring. In his report he noted: ‘The
cornea was taken from another animal of the same species brought in wounded but not quite dead;
adhesion took place and 10 days after the operation, the animal gave unequivocal signs of vision, and the
upper part of the transplanted cornea remained perfectly transparent’.[13]
Unaware of the importance that Bigger had performed a within-species allograft (gazelle to gazelle), this
achievement inspired New York based ophthalmologist Richard Kissam to perform the first recorded
therapeutic corneal xenograft on a human in 1838.[14] The recipient was a young Irishman with
perception of light visual acuity in his only functional eye. The donor was a 6-month-old pig. Kissam
removed the opaque cornea with a Beer cataract knife and attached the graft with two sutures placed at 3
and 9 O’clock. These sutures were removed after 36 h. While there was ‘increased light perception’ in the
immediate postoperative period, the cornea opacified within the first fortnight and was absorbed within the
1st month.
For the remainder of the 19th century, the pioneers of corneal transplantation were divided between those
who favored xenografts and those who favored allografts. However, neither side of the argument had the
advantage of an immunologic understanding of transplantation.
The German professor, Arthur von Hippel (1841-1916),[1] who developed a number of graft instruments
including a clockwork trephine, advocated lamellar xenografts, whereas the English ophthalmologist
Henry Power[15] favored allografts. Power believed that allografts had ‘better matched thicknesses’ and
was also the first to really understand the importance of allografts in terms of failure. These eminent
ophthalmologists also disagreed on the ideal form of corneal transplantation. Von Hippel promoted
lamellar grafts as he believed that corneal transparency depended on the integrity of the endothelium and
Descemet's membrane. Power, however favored penetrating keratoplasty.
The Modern Era Go to:
In the modern era, corneal transplantation was the forerunner in developments of human organ
transplantation. Indeed, the first successful human corneal transplant was performed in 1905, and there
was an interval of 49 years before the first successful solid organ (kidney) transplant;[16] an eon in the
modern medical timeline. Like many achievements in medicine, progress in corneal transplantation was
hindered by a lack of understanding of antiseptic principles, anesthesiology, surgical technique, and
immunology.[17,18]
Developments in the practical achievement of corneal transplantation are marked by the recognition and
surmounting of these obstacles. Pivotal achievements include the development of anesthesia in the late
19th century, the publication of Lister's principles of antiseptic surgery in 1867,[19] the pioneering work by
Medawar and Billingham et al., in the field of immunology in the 1940s and 1950s,[20,21] the recognition
of the immunological phenomenon of corneal graft rejection by Paufique et al.,[22] and later Maumenee;
[23] and the increasing availability of antibiotics in the 1940s and corticosteroids in the 1950s.[1,24,25]
The final ingredients were the introduction of nylon sutures by Ethicon specifically for keratoplasty in the
1960s and the introduction of surgical microscopes into ophthalmology the late 1960s and early 1970s.
The year 1905 marked the first successful human allograft performed by Eduard Zirm (1887-1948) in
Olmutz near Prague [Figure 1].[26] The recipient was a 45-year-old Alois Glogar; a farm laborer who had
sustained severe bilateral alkali burns while cleaning out a chicken coop with lime 16 months earlier. The
living donor was an 11-year-old boy whose eye had been blinded by a penetrating injury to the sclera. The
donor eye was enucleated prior to transplantation and the one cornea was used to provide two 5 mm donor
grafts.
Although the graft in the right eye failed, the surviving graft in the left eye improved the patient's visual
acuity from counting fingers to 6/36 at 6 months. Zirm subsequently recommended the following points
for successful corneal transplantation; exclusive use of human corneas (preferably from young and healthy
donors), use of the von Hippel trephine, deep anesthesia, strict asepsis, overlay sutures, use of an AC
maintainer, avoidance of touching tissue, and placement of the graft between moist gauze for protection
prior to transplantation.
Since the first successful corneal transplant, innumerable ophthalmologists have contributed to the
development and refinement of corneal transplantation. Their collective achievements allowed improved
surgical methodology, technology, and instrumentation; improved understanding of corneal biology; and
better control of rejection through anti-inflammatory agents.
Three of these deserve special mention. The Russian ophthalmologist Vladimir Filatov (1875-1956) first
suggested the use of cadaver corneas ‘in the attempt to find a new source of transplant corneas if the
serious difficulty of supply was to be overcome’.[27] This idea was further developed by the American
ophthalmologist Richard Paton who established the first eye bank in 1944.[28] Another notable
ophthalmologist is the Spanish Ramon Castroviejo (1904-1989) who conducted detailed studies of graft
technique in the United States [Figure 2].[29,30] He popularized the use of direct sutures, and was
innovative in surgical instrumentation. Several modern instruments bear his name.
The Future Go to:
The major limitations of modern day corneal transplantation surgery may be classified under the following
headings; paucity of donor tissue, graft rejection and failure, and variable visual and tectonic outcomes.
Evolution in the field of corneal transplantation is therefore targeted towards overcoming these obstacles.
Recent developments with the potential to transform corneal transplant surgery include: A revival of
anterior and posterior lamellar techniques [Figure 3], the artificial or bioengineered cornea, the
manipulation of corneal endothelial cells as a substitute for transplantation, and the use of the surgical
femtosecond laser.[31]
Lamellar keratoplasty
Penetrating keratoplasty has traditionally been the treatment of choice for corneal opacification. In more
recent years, there has been a renaissance of anterior and posterior lamellar techniques which selectively
replace only the diseased layers of the cornea while retaining healthy layers.
Bioengineered cornea
The artificial or bioengineered cornea represents the “holy grail” of corneal transplantation; simultaneously
nullifying the dual obstacles of donor tissue availability and immunological incompatibility. Ideally, the
bioengineered cornea[32] would begin as an acellular stromal scaffold with ex vivo colonization of host
endothelial cells, keratocytes, and epithelium. The host cells would be modified to eliminate the original
disease characteristics, thereby resulting in a disease-free bioengineered tissue which is genetically and
therefore immunologically identical to the host. Mimics of corneal extracellular matrix have recently been
used as an anterior lamellar corneal transplant.[33]
Manipulation of corneal endothelial cells

Recent advances in the understanding of the cell-cycle activation pathways of endothelial cells in vitro
have allowed progress in human corneal endothelial cell culture. The transplantation of cultured corneal
endothelial cells has met with some success in experimental settings.[34,35,36,37,38,39] In future clinical
practice, cultured endothelial cells may be implanted either as a monolayer or by injection into the anterior
chamber.[31]
Ophthalmic femtosecond lasers

Ophthalmic femtosecond lasers are capable of creating precise cuts in the cornea with minimum collateral
damage to surrounding tissue, and are being used to perform accurate corneal trephination for donor and
recipients. The high degree of accuracy offered by the femtosecond laser may translate into better visual
and tectonic outcomes though there are insufficient data to support this conjecture at present.[31]
Conclusion Go to:
From mythological and allegorical tales to reality, corneal transplantation is now established as the most
common and indeed the most successful form of human transplantation. Corneal transplantation continues
to evolve and emerging techniques offer the potential of a truly customized personal transplant material
within a generation.
Footnotes Go to:
Source of Support: Nil
Conflict of Interest: None declared.
References Go to:
1. Moffatt SL, Cartwright VA, Stumpf TH. Centennial review of corneal transplantation. Clin Experiment
Ophthalmol. 2005;33:642–57. [PubMed: 16402960]
2. Starzl TE. History of clinical transplantation. World J Surg. 2000;24:759–82. [PMCID: PMC3091383]
[PubMed: 10833242]
3. Thompson DF. 2nd ed. Oxford: Oxford University Press; 1996. The Oxford modern English dictionary.
4. Homer, Callan N, Mack MtE, Pope AWteoab P. The Illiad of Homer. ([Translated by] Alexander Pope.)
Associate editors: Norman Callan [and others], etc. In: Maynard Mack., editor. London, New Haven:
Methuen and Co, Yale University Press; 1967.
5. Anastas CN, McGhee CN, Webber SK, Bryce IG. Corneal tattooing revisited: Excimer laser in the
treatment of unsightly leucomata. Aust N Z J Ophthalmol. 1995;23:227–30. [PubMed: 8534450]
6. Dewhurst J. Cosmas and Damian, patron saints of doctors. Lancet. 1988;2:1479–80.

[PubMed: 2904584]
7. Dante A, Raffel B, Carrigan HL. Evanston, Ill: Northwestern University Press; 2010. The divine
comedy.
8. Pellier de Quengsy G. Paris: Didot; 1789. Précis ou cours d’opérations sur la chirurgie des yeux par
M.G. Pellier de Quengsy, fils.
9. Darwin E. Erasmus Darwin: Dublin: Printed for P. Byrne; Zoonomia, or, the laws of organic life.
10. Coster DJ. A century of corneal transplantation. Clin Experiment Ophthalmol. 2005;33:557–8.
[PubMed: 16402939]
11. Reisinger F. Die keratoplastik, ein versuch zur enweiterund der augenheilkunde. Bayerische Annalem.
1824;1:207.
12. Dieffenbach J. Beitrage zur Verpflanzung der Hornhaut. Festschr Ophthalmol (von Ammon)
1831;1:172–6.
13. Bigger S. An inquiry into the possibility of transplanting the cornea with a view to relieving blindness.
Dublin J Med Sci. 1837;11:408–17.
14. Kissam R. Ceratoplastics in man. NY J Med. 1844;2:281–2.
15. Power H. On transplantation of the cornea. IV International Congress of Ophthalmology.

1873;IV:172–6.
16. Merrill JP, Murray JE, Harrison JH, Guild WR. Successful homotransplantation of the human kidney
between identical twins. J Am Med Assoc. 1956;160:277–82. [PubMed: 13278189]
17. Groth CG, Brent LB, Calne RY, Dausset JB, Good RA, Murray JE, et al. Historic landmarks in clinical
transplantation: Conclusions from the consensus conference at the University of California, Los Angeles.
World J Surg. 2000;24:834–43. [PMCID: PMC2967280] [PubMed: 10833252]
18. Calne R. The history and development of organ transplantation: Biology and rejection. Baillieres Clin
Gastroenterol. 1994;8:389–97. [PubMed: 8000088]
19. Lister J. On the Antiseptic Principle in the Practice of Surgery. Br Med J. 1867;2:246–8.
[PMCID: PMC2310614]
20. Medawar PB. Immunity to homologous grafted skin; the fate of skin homografts transplanted to the
brain, to subcutaneous tissue, and to the anterior chamber of the eye. Br J Exp Pathol. 1948;29:58–69.
[PMCID: PMC2073079] [PubMed: 18865105]
21. Billingham RE, Brent L, Medawar PB. The antigenic stimulus in transplantation immunity. Nature.
1956;178:514–9. [PubMed: 13358786]
22. Paufique L, Sourdille G-P, Offret G, Paufique L. Paris: Masson (Alençon, Impr. alençonnaise); 1948.
L. Paufique, G-P. Sourdille, Guy Offret, Les Greffes de la cornée, kérato-plasties, rapport présenté à la
Société française d’ophtalmologie le 23 mai 1948.
23. Maumenee AE. The influence of donor-recipient sensitization on corneal grafts. Am J Ophthalmol.
1951;34:142–52. [PubMed: 14829525]
24. Mannis MJ, Krachmer JH. Keratoplasty: A historical perspective. Surv Ophthalmol. 1981;25:333–8.
[PubMed: 7013131]
25. Forstot SL, Kaufman HE. Corneal transplantation. Annu Rev Med. 1977;28:21–35. [PubMed: 324359]
26. Zirm E. Eine erfolgreiche totale keratoplastik. Arch Ophthalmol. 1906;64:580–93.
27. Filatov V. Transplantation of the cornea from preserved cadavers’ eyes. Lancet. 1937;1:1395–7.
28. Paton D. The founder of the first eye bank: R. Townley Paton, MD. Refract Corneal Surg. 1991;7:190–
5. [PubMed: 2043567]
29. Castroviejo R. Keratoplasty. Am J Ophthalmol. 1941;24:1–20.
30. Polack FM. Ramon Castroviejo 1904-1987. Cornea. 2000;19:593–602. [PubMed: 11009311]
31. Tan DT, Dart JK, Holland EJ, Kinoshita S. Corneal transplantation. Lancet. 2012;379:1749–61.
[PubMed: 22559901]
32. Griffith M, Osborne R, Munger R, Xiong X, Doillon CJ, Laycock NL, et al. Functional human corneal
equivalents constructed from cell lines. Science. 1999;286:2169–72. [PubMed: 10591651]
33. Fagerholm P, Lagali NS, Merrett K, Jackson WB, Munger R, Liu Y, et al. A biosynthetic alternative to
human donor tissue for inducing corneal regeneration: 24-month follow-up of a phase 1 clinical study. Sci
Transl Med. 2010;2:46ra61.
34. Yokoo S, Yamagami S, Yanagi Y, Uchida S, Mimura T, Usui T, et al. Human corneal endothelial cell
precursors isolated by sphere-forming assay. Invest Ophthalmol Vis Sci. 2005;46:1626–31.
[PubMed: 15851561]
35. Sumide T, Nishida K, Yamato M, Ide T, Hayashida Y, Watanabe K, et al. Functional human corneal
endothelial cell sheets harvested from temperature-responsive culture surfaces. FASEB J. 2006;20:392–4.
[PubMed: 16339916]
36. Ruberti JW, Zieske JD. Prelude to corneal tissue engineering-gaining control of collagen organization.
Prog Retin Eye Res. 2008;27:549–77. [PMCID: PMC3712123] [PubMed: 18775789]
37. Peh GS, Beuerman RW, Colman A, Tan DT, Mehta JS. Human corneal endothelial cell expansion for
corneal endothelium transplantation: an overview. Transplantation. 2011;91:811–9. [PubMed: 21358368]
38. Okumura N, Ueno M, Koizumi N, Sakamoto Y, Hirata K, Hamuro J, et al. Enhancement on primate
corneal endothelial cell survival in vitro by a ROCK inhibitor. Invest Ophthalmol Vis Sci. 2009;50:3680–7.
[PubMed: 19387080]
39. Mimura T, Yamagami S, Usui T, Ishii Y, Ono K, Yokoo S, et al. Long-term outcome of iron-
endocytosing cultured corneal endothelial cell transplantation with magnetic attraction. Exp Eye Res.
2005;80:149–57. [PubMed: 15670793]
Figures and Tables Go to:
Table 1
Considering the evolution and progress of corneal transplantation in terms of seven major epochs
Table 2
Open in a separate window
Major landmarks in the evolution of corneal transplantation 1800-2000
Figure 1
Dr. Eduard Zirm, the first to perform a successful penetrating keratoplasty (1905) in his operating theatre
Figure 2
Dr. Ramon Castroviejo (right) who was largely responsible for popularizing penetrating keratoplasty in the USA in 1930s
and Dr. R. Townley Paton (left), performing one of the first corneal transplants in New York, 1937
Figure 3
Three examples of contemporary corneal transplant surgery: (a) Deep anterior lamellar keratoplasty (DALK) with
removal of host stroma down to Descemet's membrane, (b) penetrating keratoplasty (PKP) with combination of
interrupted (10-0) and continuous (11-0) sutures, and (c) Descemet's stripping endothelial keratoplasty (DSEK) with the
graft host interface visible in the periphery (arrow)
Articles from Oman Journal of Ophthalmology are provided here courtesy of Wolters Kluwer -- Medknow
Publications

A Brief History of Corneal Transplantation - From Ancient To Modern

Uploaded by

Document Information

Original Title

Copyright

Available Formats

Share this document

Share or Embed Document

Sharing Options

Did you find this document useful?

Is this content inappropriate?

Copyright:

Available Formats

A Brief History of Corneal Transplantation - From Ancient To Modern

Uploaded by

Copyright:

Available Formats

4/8/2018 A brief history of corneal transplantation: From ancient to modern

Oman J Ophthalmol. 2013 Sep-Dec; 6(Suppl 1): S12–S17. PMCID: PMC3872837

A brief history of corneal transplantation: From ancient to modern

Copyright : © 2013 Crawford AZ, et al

Keywords: Cornea, history, keratoplasty, transplantation

Before Modern Times: Myth to Theory Go to:

Theory to Practice Go to:

A contemporary of Reisginer, Johan Dieffenbach (1792-1847), also experienced repeated failures in

The Modern Era Go to:

The Future Go to:

Manipulation of corneal endothelial cells

Ophthalmic femtosecond lasers

Source of Support: Nil

Conflict of Interest: None declared.

6. Dewhurst J. Cosmas and Damian, patron saints of doctors. Lancet. 1988;2:1479–80.

14. Kissam R. Ceratoplastics in man. NY J Med. 1844;2:281–2.

15. Power H. On transplantation of the cornea. IV International Congress of Ophthalmology.

26. Zirm E. Eine erfolgreiche totale keratoplastik. Arch Ophthalmol. 1906;64:580–93.

29. Castroviejo R. Keratoplasty. Am J Ophthalmol. 1941;24:1–20.

Figures and Tables Go to:

Open in a separate window

Major landmarks in the evolution of corneal transplantation 1800-2000

You might also like