The castroviejo square graft: wound healing after 51 years

To describe the histopathologic characteristics of a 51-year-old Castroviejo square graft that remained functional for more than 50 years and to describe the wound-healing characteristics over this period of time.

An 80-year-old woman with a history of keratoconus underwent penetrating keratoplasty with square grafts in 1956 and 1957 in the right and left eyes, respectively. The graft from the right eye was replaced in 2007, and the corneal specimen was submitted for histopathologic analysis.

Light microscopy demonstrated a smooth transition between host and donor stroma. Descemet's membrane was markedly thickened (>40 m) and laminated, and a very thin retrocorneal membrane was visible at high magnification.

This case provides an opportunity to observe the histopathology of corneal wound healing over a period of more than half a century.