OBJECTIVE To compare the intraocular pressure (IOP) during the first postoperative year after penetrating keratoplasty (PK) and Descemet's stripping automated endothelial keratoplasty (DSAEK). METHODS Retrospective chart review. METHODS Fifty-three pseudophakic eyes of 53 patients who underwent PK or DSAEK because of endothelial dysfunction between January 2006 and December 2010 were included. METHODS Surgeries consisted of 19 (35.8%) PK procedures and 34 (64.2%) DSAEK procedures. Demographic, preoperative, and postoperative data including IOP, number of medications, rejection and occurrence, and complications were recorded. RESULTS Patients who had undergone DSAEK had statistically significant lower IOP throughout 12 months after surgery than those who had undergone PK (p = 0.028), despite similar use of IOP-lowering medications during this time. Measurements of postoperative IOP greater than 21 mm Hg and greater than 30 mm Hg were significantly more common in patients who had undergone PK than DSAEK (p = 0.015 and 0.022, respectively). Complication rates were similar between the 2 groups. IOP was not correlated with patient age, sex, background illnesses, or previous glaucoma. CONCLUSIONS IOP is significantly lower after DSAEK compared with PK. Several mechanisms explaining this difference are proposed. New corneal transplantation modalities such as DSAEK, with a better postoperative IOP control, may reduce the risk for later visual loss caused by postoperative glaucomatous damage.