Background: Astigmatism after keratoplasty continues to be a difficult case for corneal refractive surgeons. Astigmatism is a barrier to visual recovery after a successful corneal transplant, even though graft viability is the primary concern in keratoplasty. Aim and objectives:The aim of the study was to assess the management of postoperative   penetrating keratoplasty astigmatism by photorefractive keratectomy. Subject and methods: Study was done between March 2021 and March 2022 at Al-Nahar eye center (Assiut).  30 eyes of 30 patient underwent PTK-PRK (phototherapeutic keratectomy and photorefractive keratectomy), all were done by the same surgeon.       Results: The BCVA (Best Corrected Visual Acuity) of the studied eyes ranged from 0.01 to 0.2 with a median value of  0.1 and IQR between (0.1 and 0.2) preoperatively, which was significantly improved after 1 month to have a median value of 0.5 and IQR between (0.4 and 0.58, P=0.003) and kept improving significantly after 2 and 3 months by comparison to preoperative to have a median of 0.7 with IQR (0.7: 0.8) after 2 months and all eyes had a BCVA of 0.8 after 3 months (P<0.001). Conclusion: Clear graft penetrating keratoplasty (PK) improves eyesight. Significant postoperative astigmatism, however, may impair visual acuity to some degree. After keratoconus, patients with astigmatism have more than one treatment option available.