Penetrating keratoplasty is a sight saving operative procedure especially incountries where corneal opacification is rather common. The success rate of this procedure has been improving dramatically in the past decade. In spite of a successful surgical procedure and outcome the visual rehabilitation may behampered by ametropia in all its forms. The objective and aim of this study is to review the various modalities available to overcome this visual handicapping ametropia. New tools and advancement in technology in various refractive procedures offers glimmers of hope in the visual rehabilitation of post keratoplasty ametropia.Post keratoplasty ametropia may be present in the following forms; astigmatic,hypermetropic and myopic ametropia. In this essay we reviewed the possiblemodalities in managing these conditions.