[Corneal transplantation]

The first successful corneal transplantation was done in 1906, when the corneas of a recently deceased boy were transferred to a man blinded by an alkali burn. Since then, improved equipment, microsurgical technique and better methods for treating postoperative complications have greatly improved the prognosis of corneal grafting. Immunological reactions are less frequently seen after keratoplasty than after other types of transplantation, and the graft is also directly accessible for immunosuppressive treatment. Penetrating keratoplasty accounts for more than 95% of all corneal transplantations in Norway, the other procedures being lamellar grafting and epikeratophakia. While keratitis and macula corneae previously were the main indications for keratoplasty, keratoconus is at present the most frequent indication. The prognosis is poorer in eyes with extensive vascularization, lacking sensibility, insufficient tear secretion and marked symblepharon. Due to shortage of suitable donor tissue, the waiting lists for this type of ocular surgery are increasing.