We studied the results in six cases of penetrating keratoplasty in Fuchs' dystrophy and bullous keratopathy. The prognosis has improved considerably in the last decade because of the advances and improvements in the fields of anesthesia, new drugs, better instrumentation, more refined surgical techniques performed under microscopic control, more meticulous selection of the graft, better knowledge of biologic mechanisms, and progress in the prevention, diagnosis, and management of complications.