We studied 180 consecutive corneal transplants performed by one surgeon to determine the benefit obtained by using a 0.5 mm oversize (OS) graft. We compared 61 same size (SS) grafts to 119 oversize (OS) grafts, with a mean follow-up time of 24 and 13 months respectively. While the refractive error, recovery of visual acuity, and intraocular pressure were similar in both groups, the astigmatism was found to be significantly elevated in the (OS) group. Using a 0.5 mm oversize graft did not afford any protection against postkeratoplasty glaucoma, did not increase the speed of recovery of the patients' visual acuity, but produced significantly more astigmatism than a same size graft.