The author reports on the experience with 75 cases of optical keratoprosthesis performed since 1967. The keratoprosthesis were carried out either by intracorneal anchoring or according to Strampelli as osteo-odonto-keratoprosthesis. Short-term improvement (up to one year) was achieved in 25% of the cases, there was a improvement (up to 14 years) in eight patients. The operation had to repeated in 30%. The keratoprosthesis is anchored under a firmly attached flap of oral mucosa transplanted to the cornea after cataract operation. Common complications are glaucoma, hypotony syndrome, extrusion of the implant, development of a retroprosthetic membrane and retinal detachment. Only in cases of severe damage to the cornea after alkali or acid burns, trauma, or pemphigoid and failure of previous keratoplasties is a keratoprosthesis indicated. The degree of improvement usually depends on the pre-existing damage to the eye. The possibilities of keratoprosthesis are limited and functional improvement is frequently only of short duration. Intensive counseling and patient care are essential pre-requisites.