Thirty-six eyes underwent cyclocryotherapy after penetrating keratoplasty for medically unmanageable elevated intraocular pressures. Thirty were controlled with one procedure, five required three procedures. Eighty-two percent of the transplants remained clear after cryotherapy and 19 of 23 with clear grafts obtained useful visual acuity. Our results including the number of patients whose glaucoma was controlled by this procedure and the percent of clear grafts following cryotherapy are far better than results of other forms of glaucoma surgery after keratoplasty. The complication rate was 14% for all procedures. Most procedures were performed within 12 weeks of the corneal transplant. Cyclocryotherapy is necessary for the successful management of glaucoma after penetrating keratoplasty to avoid graft failure and must be performed if acceptable visual acuity is to be attained.