Penetrating keratoplasty or full-thickness corneal transplantation has been,until recently, the gold standard for treatment of corneal diseases regardless of which layer of the cornea is truly pathologically changed. Corneal transplantation surgery has been intensely developing for the last fifteen years resulting in the ability to transplant only the inner or outer layer of the cornea. Such microsurgical procedures are called anterior or posterior lamellar keratoplasty. Anterior lamellar keratoplasty is a procedure by which only the outer layer of the cornea, namely the epithelium and stroma, is transplanted, while the remaining inner layer consisting of Descemet’s membrane and the endothelium is preserved. Posterior lamellar keratoplasty consists of transplanting the inner layer of the cornea including the endothelium, Descemet’s membrane and a thin layer of the stroma. By using this procedure epithelium and stroma remain intact. The foundations of the modern posterior lamellar keratoplasty were established in 1998. This was the first time that the posterior lamellar keratoplasty was successfully performed in which air was used for the fixation of the donor lamella in the anterior chamber instead of stitching of the cornea. Further modifications to the posterior lamellar keratoplasty resulted in the two main variants which are in use today: Descemet’s stripping (automated) endothelial keratoplasty (DS(A)EK) and Descemet membrane endothelial keratoplasty (DMEK). DS(A)EK is a microsurgical procedure in which the Descemet’s membrane and endothelium are transplanted with a thin layer of the stroma. In contrast, DMEK is a procedure by which only the Descemet’s membrane with associated endothelium is transplanted. The main indications for the posterior lamellar keratoplasty are diseases and conditions in which the inner endothelial layer does not function. In practice, these are primarily bullous keratopathy and Fuchs' corneal endothelial dystrophy. It is necessary to prepare a donor corneal lamella to be able to carry out the posterior lamellar keratoplasty. The preparation can be done in the eye bank or by a surgeon during surgery. Automatic microkeratome is required to crop the donor lamella of appropriate thickness. Posterior lamellar keratoplasty has many advantages compared with penetrative keratoplasty. The advantages of posterior lamellar keratoplasty are shorter time of operation, faster recovery of vision, lower risk of intraoperative complications and lower postoperative astigmatism. The main problems that can occur after performing posterior lamellar keratoplasty are dislocation and graft failure.