The follow up time after keratoplasty now routinely exceeds multiple decades. It is common for keratoplasty patients to also undergo cataract surgery at a later date in their lives.

Keratoplasties and cataract surgery both result in local inflammation. This may influence the density of endothelial cells, and on average there is a loss of 10% in endothelial cells within 3 months of the cataract surgery. Yet, a sufficient density of endothelial cells is required to maintain graft transparency. It may be therefore difficult to strike a balance between loss of visual acuity due to the cataract of to the loss of graft transparency over the long term.

The investigators aim to compare graft survival in patients with clear crystalline lens with and without cataract surgery.

Inclusion Criteria:

• All patients undergoing keratoplasty
• Between january 1983 and december 2012
• Age 40 and older at the time of surgery

Exclusion Criteria:

• Cataract surgery prior to the keratoplasty
• Systemic inflammatory disease
• Previous history of uveitis

All patients who underwent a keratoplasty between january 1983 and december 2012 at the University Hospital of Besançon.