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The Boston keratoprosthesis (KPro) is an advanced artificial device designed to restore vision in patients suffering from severe ocular surface disease or irreversible corneal opacification, conditions where traditional corneal transplantation may be ineffective or impossible. This innovative approach is particularly beneficial for individuals who have undergone multiple failed corneal transplants or have significant scarring and visual impairment due to conditions such as Stevens-Johnson syndrome, chemical burns, or degenerative corneal diseases. The Boston KPro consists of a clear polymer stem that functions as an artificial cornea and is designed to be implanted into the eye, where it replaces the damaged or opaque cornea. Its structure is transparent, allowing light to pass through, thereby enabling vision restoration for those afflicted with severe corneal issues. The procedure to implant the Boston KPro involves removing the diseased cornea and inserting the KPro device, which is then secured in place with a retention plate that sits behind the eye's sclera. This technique helps to mitigate potential complications such as dislocation or rejection that are often associated with human donor corneas. The Boston KPro is categorized into two main designs: the type 1 KPro, which is indicated for patients with less severe ocular surface disease, and the type 2 KPro, which is designed for those with significant ocular surface problems. The KPro incorporates a central optical stem made of a transparent material, allowing light to enter the eye and focus properly onto the retina, thus restoring the patient's ability to perceive visual stimuli. One of the remarkable features of the Boston KPro is its ability to promote a moist ocular surface, which is a key factor in sustaining the health of the eye and providing comfort to users. Patients typically experience improved vision quality after implantation, and many report significant enhancements in their overall quality of life. Despite its advantages, candidates for the Boston KPro must be thoroughly evaluated to ensure optimal outcomes, as there are potential risks, including infection, retinal detachment, and continued inflammation of the ocular surface. Long-term follow-up and careful management are essential to address these risks and to ensure the longevity of the device. While the Boston keratoprosthesis does not replace the need for lifelong monitoring and management, it represents a significant advancement in ophthalmic surgery and offers hope to those who have exhausted traditional treatment options. Overall, the Boston KPro stands as a groundbreaking solution in the field of corneal surgery, offering renewed vision and hope for countless individuals suffering from blinding corneal diseases.