Ramón Castroviejo (1904–1987): The father of the modern corneal transplantation

Abstract

Ramón Castroviejo Briones was born in 1904 in Logroño, Spain. He received his medical education at the University of Madrid, where he graduated in 1927. In 1929, he received a fellowship to work as assistant in the Ear, Nose, and Throat Hospital and College of Chicago. In 1930, he passed his American Board Examination and returned to Europe to visit the centers where keratoplasty was a fact. He visited the University eye clinics of Madrid, Paris, Vienna, Berlin, and Prague. When he returned to the United States, Castroviejo had a clear idea of what was being done in Europe and what he hoped to achieve. William L. Benedict had offered him a research fellowship at the Mayo Clinic, in Rochester, Minnesota, which Castroviejo accepted. In 1932, Dr. Maynard C. Wheeler granted Castroviejo a Research Fellowship at the new Eye Institute of the College of Physicians and Surgeons of Columbia University. He moved to New York, where he continued his research in animals in the Eye Institute of the Columbia Presbyterian Medical Center, and was an early developer of techniques for transplanting corneal tissue from the eyes of those who had just died to damaged eyes of the living. While not being the first to successfully graft human cornea, he improved the technique of the operation in the 1930s and 1940s, prompting the worldwide adoption of corneal transplantation as a standard way to deal with severe corneal pathology. His keratoplasty technique, creating a rectangular rather than circular “window” in the cornea, was the secret to his successful transplants, and remained standard until more efficient suture materials became available. The surgeon described this technique in 1937 to the American College of Surgeons. He contended that rectangular windows gave better results than the circular ones that had been tried earlier, since their edges could be fitted better to merge with and become a living part of the rest of the eye. Although the medical community was slow to recognize his successes, Castroviejo was eventually lauded for his sight‐saving corneal tissue transplant techniques, which he continued to refine and teach for many years. Castroviejo also promoted the donation of corneal tissue in the United States and designed numerous ophthalmic instruments, including the Castroviejo needle holder ‐an instrument used in eye, dental and other forms of microsurgery‐ Castroviejo callipers and corneal scissors. He became the director of Ophthalmology at St. Vincent's Hospital before he opened his own hospital when he bought the Hammond House in New York. After closing his private hospital he retired as clinical professor of the University of New York and moved permanently to Madrid, where he founded the Instituto Castroviejo, at the Complutense University of Madrid, and organized the Spanish Eye Bank, maintaining extensive clinical activity whenever his health permitted. Ramón Castroviejo died in 1987, at the age of 82, and is widely recognized as one of the 10 most influential people in ophthalmology of the 20th century.