Despite scientific advances, corneal grafting is still in a crucial situation in France in 1999. Over the last 3 years, the number of corneal grafts (2 903 in 1996, 3 213 in 1997, and 4 053 in 1998) has been insufficient to satisfy estimated needs (8 041 in 1996, 8 303 in 1997, 7 400 in 1998). The consequences are waiting lists, long time on waiting lists, and regional differences. This situation results more from difficulties in the cornea procurement system than from limited numbers of potential donors or restricted selection criteria. Progress will depend greatly on structural changes.