A brief history of keratoplasty.

Abstract

The first successful corneal transplantation, performed by Eduard Zirm in 1905, marked a turning point in treating corneal blindness. This breakthrough was preceded by centuries of conceptual development, dating back to Galen's theoretical approach to corneal transparency restoration in ancient Rome. Erasmus Darwin later proposed corneal trephination in the 18th century, though without practical implementation. The 19th century saw a surge in experimental keratoplasty, with Karl Himley suggesting cross-species corneal transplants and Franz Reisinger coining the term 'keratoplasty'. Johann Dieffenbach and Samuel Bigger further explored transplantation in animal models. Arthur von Hippel's innovations in trephination laid the foundation for Zirm's success, who performed the first human-to-human corneal transplant using strict aseptic techniques. Subsequent advancements, including the establishment of eye banks, immunosuppressive therapies and modern lamellar keratoplasty techniques like DSAEK and DMEK, have significantly improved graft survival and visual outcomes. This historical perspective highlights the continuous evolution of corneal transplantation, underscoring the contributions of numerous pioneers whose innovations have shaped modern ophthalmology.