251 eyes underwent the combined procedure of perforating keratoplasty and intracapsular cataract extraction from 1968 to 1983. The preoperative preliminaries as well as the intraoperative details are described. The histological diagnoses were Fuchs’ endothelial-epithelial dystrophy, keratoconus, leukoma adherens and different kinds of keratitis. 89% of the grafts were clear, 11% irreversibly cloudy. Visual acuity was improved in 88%. Postoperative high intraocular pressure was no special problem and not affected by the combined procedure. Vitreal complications were seen in only 14%. The diameter for transplant and patient’s cornea can be reduced to 7.3 mm for both.