Intraoperative positive pressure with resulting iris and lens prolapse can pose a difficult scenario during penetrating keratoplasty. In the Price graft-over-host technique, the graft is sutured across the trephinated host cornea, which maintains a formed anterior chamber and thus avoids intraoperative complications. The technique was used in 33 eyes, and no primary or secondary graft failures occurred. Eleven episodes of acute rejection in 11 eyes were treated successfully with steroids.