The occurrence of chronic postoperative glaucoma in 502 consecutive penetrating keratoplasty cases performed in 421 patients during 1978 through 1986 was 18% (91 cases). Immediate postoperative glaucoma occurred in 9% (44 cases) and progressive angle closure occurred in 2% (13 cases) of keratoplasties. Statistically significant risk factors for development of glaucoma were preexisting glaucoma and aphakia. The type of cataract extraction, use of an intraocular lens, or performance of vitrectomy did not pose significant risk of glaucoma. Surgical therapy of glaucoma was required in 24% of those with glaucoma and was most effective as cyclodestructive surgery especially in patients with progressive angle-closure glaucoma.