Purpose. To evaluate intraocular pressure after homologous central penetrating keratoplasty. Methods. The study included 245 patients undergoing homologous central penetrating keratoplasty for keratoconus (n=77), herpetic scars (n=29), non-herpetic corneal scars (n=46), Fuchsґ endothelial dystrophy (n=24), and secondary corneal endothelial decompensation due to preceding intraocular operations (n=69). Mean follow-up time was 30.4 ± 18.7 months (range, 12.1 to 111.6 months). All patients were operated upon by the same surgeon and a peripheral iridotomy was routinely performed. Results. On the first postoperative day, IOP was significantly (p=0.02) higher than prior to keratoplasty. IOP measurements determined at the third postoperative day (p=0.57), one week after surgery (p=0.55), or determined later (p>0.50), were not significantly different from the preoperative values. Eyes undergoing keratoplasty with cataract surgery and eyes undergoing keratoplasty without additional intraocular procedures did not vary significantly (p>0.10) in IOP measurements. IOP did not differ significantly (p>0.50) between eyes (n=29) with an immunologic graft reaction and eyes (n=216) without a reaction. Acute angle-closure glaucoma was not detected in any of the patients. IOP measurements were statistically independent of suture type, age, preoperative and postoperative refractive error, preoperative and postoperative corneal astigmatism, preoperative and postoperative visual acuity, diameter of graft and trephine, and oversize of the graft. Postoperative IOP measurements were significantly (p<0.01) correlated with preoperative IOP values. Conclusions. In eyes with a peripheral iridotomy performed during surgery, homologous central penetrating keratoplasty usually does not markedly change intraocular pressure. The main risk factor for postoperatively elevated IOP is elevated IOP prior to surgery.