​Keratoplasty techniques have evolved in the last 15 years into a variety of forms, which have diversified the previous monographic presence of the penetrating keratoplasty technique. The development of anterior lamellar graft (DALK), and posterior lamellar graft (DSAEK), makes an important change in the approach to lamellar surgery. Later on, the appearance of DMEK and superficial lamellar keratectomy broadened the spectrum. Today, intralamellar surgery has evolved with a number of techniques that involve stromal enhancement with biologically active or acellular corneal laminas from donors, customized lenticles from SMILE surgeries or customized by corneal topography, and more recently, corneal regeneration of the stroma by advanced techniques using mesenchymal stem cells.