The technique of keratoprosthesis was used in 21 cases of severe and intractable forms of keratopathy during the past 3 1/2 years. The results in terms of visual acuity were satisfactory in more than half the cases. Significant problems that occurred after this procedure included the diagnosis and management of glaucoma, vitreitis, and retroprosthetic membrane. There were no instances of extrusion of the keratoprosthesis nor were there any cases of endophthalmitis. However, one case developed necrosis of the tissue around the optical cylinder on the eyelid after surgery. Although its use is limited to only some forms of keratopathy, keratoprosthesis seems to offer a solution in cases where no other treatment is available.