Abstract Purpose: The management of severe ocular surface diseases and end‐stage dry eye disorders such as Stevens Johnson syndrome, ocular cicatricial pemphigoid and chemical burns with conventional keratoplasty or keratolimbal allografting remains unsatisfactory. The Osteo‐Odonto Keratoprosthesis (OOKP) is a form of keratoprosthesis (artificial cornea) surgery designed to treat the most severe of these cases, and good outcomes with long‐term retention have been reported. We present the moderate‐term clinical results of Asian patients who have had this device implanted within our Singapore OOKP Program. Methods: OOKP surgery involves a radical two‐stage procedure – in stage 1, an autologous canine tooth is removed, modified to receive an optical PMMA cylinder, and implanted into the cheek. The entire ocular surface is denuded and replaced with a full thickness buccal mucosal graft. Stage 2 surgery, performed 2‐4 months later, involves retrieval of the tooth‐cylinder complex and implanting it into the cornea, after lifting of the buccal mucosal flap, corneal trephination, iris and lens removal and anterior vitrectomy. Concurrent glaucoma and vitreo‐retinal procedures may also be performed at either stage, if required. Indications for OOKP surgery include bilateral severe blindness, not amenable to keratoplasty or ocular surface transplantation or with previous failed attempts. Results: In February 2004, the Singapore National Eye Centre embarked on its OOKP program, in collaboration with the National Dental Centre. We have now performed OOKP surgery on 22 patients, with the longest follow‐up being 39 months. Of 16 patients with a mean of 19.1 months follow‐up (range 5‐39 months), no major keratoprosthesis‐related complications have occurred, with full anatomical stability and retention in all cases. 73.3% of patients attained at least 6/12 or better vision, while 90% attained 6/6 vision, and remaining patients have attained, and retained their best visual potential with the exception of one patient who lost vision unrelated to the KPro device (endophthalmitis following glaucoma surgery occurred 1 year after KPro surgery). Conclusions: OOKP surgery appears to be a highly promising procedure which has the potential to restore excellent vision to the most severe cases of end‐stage corneal disease, when all else has failed. Longer follow‐up of these cases is currently underway.