Outcomes of different modifications of top-hat keratoplasty were assessed in 48 patients (48 eyes) with bullous keratopathy. In the 1st group manual top-hat keratoplasty was performed in 7 patients. 30 patients of the 2nd group underwent manual half-top-hat keratoplasty. In the 3rd group femtosecond laser-assisted top-hat keratoplasty was performed in 11 patients. All keratoplasty techniques used in the study provide high rate of clear graft retention. Manual half-top-hat keratoplasty is technically easier compared to manual top-hat keratoplasty though having similar outcomes and does not require the use of any additional equipment. Femtosecond laser-assisted top-hat keratoplasty allows to achieve superior optical results, trephination is performed promptly and with minimal tissue trauma. This new keratoplasty technique is a promising procedure and requires further detailed investigations.