The indications for keratoplasty at Moorfields Eye Hospital were reviewed for the period 1985-1987. There were 500 consecutive cases of which 472 underwent penetrating keratoplasty and 28 lamellar keratoplasty; of the grafts performed 31 were acute procedures. The most common indication for penetrating keratoplasty was keratoconus accounting for 34.2% of cases and for lamellar keratoplasty corneal dystrophies accounting for 28.6% of cases. This contrasts with other studies which have found pseudophakic bullous keratopathy to be the leading indication for penetrating keratoplasty. Possible reasons for this difference are discussed and the current series is compared to two previous series presented from this hospital in 1959 and 1974.