The cornea group at Keio University is devoted to the treatment of various corneal diseases by minimally invasive procedures. The number of keratoplasty cases exceeds 100 a year, and we plan to accommodate more patients requiring surgery. We have adapted several new techniques to transplant and replace only those corneal components that are actually damaged. Penetrating keratoplasty has long been the standard for corneal transplantation. However, transplanting excessive tissue may not only be unnecessary, but also increase the risk of immunological rejection. Extensive surgery also affects post-surgical vision. Many of our recent cases are treated by deep lamellar keratoplasty or endothelial keratoplasty depending upon the affected corneal layer. We choose the ideal choice of surgery by discussing the various options with each patient. We will continue to improve current techniques to achieve higher quality of vision.