Academy of Ophthalmology IRIS Registry (Intelligent Research in Sight). Multivariable Cox proportional hazards models were fit to examine the relationships between sociodemographic variables and time from FECD diagnosis to penetrating keratoplasty (PK) and endothelial keratoplasty (EK)/PK. Results: A total of 20,366 patients with FECD diagnosis and subsequent corneal edema were identified. Of the 4313 patients who underwent either EK or PK (any surgery), 374 patients underwent PK, 4037 underwent EK, and 98 received both interventions. After controlling for age, sex, and insurance status, Black or African American patients were 1.48 times as likely (hazard ratio 1.48, 95% confidence intervals (CI), 1.06–2.07) to undergo PK as compared with White patients and were less likely to receive any surgery (HR 0.83, 95% CI, 0.74–0.94). Asian patients were less likely (HR: 0.57, 95% CI, 0.43–0.75) to undergo any surgery. Female patients were more likely to undergo PK and less likely to undergo an