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We have compared penetrating keratoplasty at a teaching hospital and a district general hospital (DGH). At the teaching hospital, the pathology was similar to previous reports, but at the DGH the patients were older (P less than 0.01) and had a worse prognosis. The vision in the unoperated eye was also frequently poor. The number of postoperative outpatient visits within a hospital was unrelated to the original disease, and there was no statistically significant difference between the two centres. At the DGH, a corneal transplant patient requires the outpatient resources equivalent to three matched cataract patients. The implications for medical manpower requirements are discussed.