Abstract
Corneal grafting techniques were pioneered by ophthalmologists in as early as the 19th century. Since then, numerous advances in technology and surgical techniques have made modern penetrating keratoplasty (PKP) a largely successful operation. Furthermore, optical results of PKP have improved significantly as a consequence of advances in tissue selection and preservation, techniques, trephines, and the management of postoperative astigmatism. The number of PKP operations performed in the United States decreased to less than 18,000 in 2019, in large part as a result of the development of endothelial keratoplasty. However, PKP is still a necessary and effective procedure for full-thickness pathologies such as infectious keratitis and perforations.