Does corneal transplantation have a future?

The treatment of corneal blindness has evolved significantly since its beginnings in the 18th century. At that time, French and German surgeons used glass or quartz lenses to replace defective corneas, giving rise to the first keratoprosthesis. Allogeneic corneal transplantation is a more recent development. It was the first organ transplant successfully performed on humans at the beginning of the 20th century and is today the most commonly performed transplant. Advances in surgical techniques and post-operative care have helped to make procedures more selective and less invasive, thereby reducing complications, including the risk of rejection. Alongside allogeneic transplants, keratoprosthesis have also evolved with fully synthetic, less invasive devices. They are considered when allogeneic grafts fail, but major advances in the field of graft rejection or bio-colonizable materials could significantly change the choice between these two techniques. Finally, conservative and even preventive approaches are being developed to prevent corneal blindness and thus the replacement of the eye's primary optical lens.