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To provide an update on recent advances in keratoprosthesis surgery with a focus on long-term outcomes.Reports over the past year have focused on long-term outcomes showing good anatomical and functional results. In addition, preoperative diagnosis and surgical modifications that can impact postoperative outcomes are discussed. Outcomes of primary keratoprosthesis as an option for patients with poor prognosis for traditional keratoplasty are also presented in this review.Keratoprosthesis is an option for visual rehabilitation in select patients. Current 5-year outcomes are promising but improvements in glaucoma prevention and management are needed to enhance long-term results.