Osteo-odonto-keratoprosthesis is a type of keratoprosthesis, i.e. prosthesis that replaces the cornea when neither the keratoplasty nor the transplantation of corneal limbus cells are possible. It is used in the most severe forms of ocular surface dysfunction, when other procedures have failed or are impossible. The surgical technique of the procedure had been for the first time performed and published by Strampelli, and afterwards improved by Falcinelli and standardized by the Rome-Vienna Protocol. The procedure requires a cooperation of an ophthalmic and an oral surgeon, as it involves the joining of oral and ocular surface tissues. Prior to the surgery, ophthalmological, dental and psychological assesment and preparation of a patient are done. The operation is complex and consists of several stages. It starts by preparing the ocular surface to receive an osteo-dental lamina made from the tooth. The tissues of the ocular surface are prepared and covered with a mucosal flap, usually the buccal mucosa. A suitable single-rooted tooth is extracted along with the surrounding bone and shaped in the form of a lamina with an opening for the optical cylinder. This osteo-dental lamina is implanted in a subcutaneous pocket where it will be enveloped by connective tissue within a few months. In the second stage, an osteo-dental lamina is implanted on the anterior surface of the bulbus and covered with a mucous flap. Transplant survival requires lifelong care and regular medical check-ups. The patient can achieve a satisfactory or excellent visual acuity, with a reduced visual field. The most common complications are bleeding, mucosal complications, glaucoma, resorption of the osteo-dental lamina and retinal detachment.