Indications, Contraindications and Surgical Technique in Penetrating Keratoplasty

Corneal transplantation is one of the most fascinating and challenging but, in the same time, one of the most complicated surgical procedures in ophthalmology. Due to former facts, keratoplasty has inspired, but also frustrated surgeons, as well as patients for more than one century. During that period, corneal transplantation evaluated from rough and risky experiment to delicate and highly successful procedure. Improvement in suturing material, better microsurgical instruments, introduction of surgical microscope, development of new cornea storage media and also better understanding of clinical pharmacology of anti-inflammatory medications in prevention and control of transplantation reaction, contributed to further advance in corneal transplantation. Although great advances have been made in the field of corneal transplantation and results are increasingly good, there is still scope for improvement. The search for an ideal trephine continues, as does the quest to minimize and correctly manage post-operative astigmatism. In addition, many questions remain to be answered regarding tissue matching and immunosuppression. Continued clinical and laboratory research is therefore required to refine and further improve the outcome following penetrating keratoplasty