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University of Health Sciences Turkey, Ankara Training and Research Hospital, Department of Ophthalmology, Ankara, Türkiye DOI : 10.37844/TJ-CEO.2025.20.20 Purpose: The study aims to evaluate changing trends in corneal transplant indications and surgical techniques over the last 20 years in a tertiary clinic. Materials and Methods: Records of all corneal transplants performed between 2003 and 2023 were examined retrospectively. Those in the first 10 years were called group 1, and those in the last 10 years were called group 2. The patients demographic data, keratoplasty indications, and selected surgeries were compared between the two groups. Results: The grafts of 1300 eyes of 1149 patients were evaluated. The keratoplasty indications rates were similar in both groups, and the most common indication was keratoconus (p>0.05). The most frequently performed surgery in both groups was PKP. The difference between the two groups was significant in the surgeries selected according to indications. (p<0.05). In group 2, an increase in lamellar surgeries was observed. Conclusion: Although our surgical indications have not changed in the last 10 years, the surgical options chosen for these indications have changed. The rate of lamellar surgery has increased significantly, but penetrating keratoplasty is still the most preferred surgery. Keywords : Keratoplasty indications, Penetrating keratoplasty, Lamellar keratoplasty