Corneal transplantation, also known as corneal grafting or keratoplasty is a procedure during which dysfunctional cornea is removed from a patient’s eye and replaced with healthy clear cornea from a donor. Eduard Zirm performed the first successfully full-thickness corneal transplantation more than 100 years ago (1905). Nowadays the cornea is the most successfully transplanted tissue worldwide and one of the most frequent tissue graftings in the Western world. This is especially possible because the cornea is quite suitable for tissue grafting due to its avascularity and the immunological privilege. The indications for transplantation cover a wide range of diseases. Most of them are obtained from the well-established cornea bank that is capable of preserving the excised donor tissue up to 4 weeks in culture medium. Cadaveric donor tissue is used whereas the recovery of the donor eye tissue takes place within hours of death. Surgical techniques and medical treatment of corneal grafts have changed within the last decades as well as our understanding about the immunological aspects of a corneal transplant has increased. Today we have several surgical and medical options to get a prolonged graft survival, especially in eyes with a high risk for allograft rejection. The success story of corneal transplantation began with the understanding of the immunological aspects and the introduction of topical and systemic immunosuppressive treatment. Furthermore in order to cover undersupplied regionsthe need for donor corneas has initiated efforts to synthesize artificial corneas
