Penetrating Keratoplasty or PK can be one of the most challenging procedures for the general ophthalmologist. Like all other surgical procedures it consists of a series of steps that are unforgiving and must be completed relatively perfectly to obtain an acceptable result. Failure at any one of the steps can result in high astigmatism, spherical error and even graft failure. Completed correctly, the result can look like the example above, a clear graft with barely discernible margins, astigmatism less than one diopter and an uncorrected vision of 20/25. I am going to present a series of posts that describes how we get to this result.