Therapeutic keratoplasty is a surgical procedure the main purpose of which is (1) to restore the structural integrity of the eye (tectonic keratoplasty) or (2) to resolve an infectious/inflammatory keratitis which is refractory to conventional medical therapy. Often, therapeutic keratoplasty is performed when both of these indications are present, such as in the treatment of a corneal ulcer that has been unresponsive to antibiotics, and has perforated. Therapeutic keratoplasties are generally emergent or urgent procedures in which the survival of the globe is in jeopardy. Thus, unlike optical penetrating keratoplasty, in which visual restoration is the primary goal, acute visual rehabilitation remains of secondary importance in therapeutic keratoplasty. Visual rehabilitation if necessary can always be accomplished at a later date under more controlled circumstances.