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- ArticleKok-van Alphen CC, Völker-Dieben HJ.Doc Ophthalmol. 1977 Sep 30;44(1):35-8.Thirty years' experience with perforating keratoplasty has shown us new indications for this technique, but certainly also new contra-indications. At first the prognosis of perforating keratoplasty improved because of better surgical techniques, so that the number of indications increased. Recently a better prognosis for heavily vascularized eyes has become possible thanks to HLA-matched donor material.