The AlphaCor implantation will inevitably evolve with increasing experience, but the essential principles emphasized previously will remain important: namely, care when handling the device, careful centration of the device, complete anterior coverage of the device during the stage I surgery with anterior lamella, and meticulous surgery to minimize postoperative inflammation. Above all, good patient selection, including in-depth patient education, has a critical impact on patient outcomes. The AlphaCor artificial cornea originated in the Lions Eye Institute of Western Australia as the Chirila keratoprosthesis, which entered human clinical trials in 1998 and is available commercially. During and after formal regulatory clinical trials, the authors established and modified the surgical technique and patient management. Since the device became commercially available, feedback from all user surgeons has contributed substantially to the available information and continues to assist with establishment of indications and techniques. The AlphaCor device (CooperVision Surgical, Perth, Australia) and the standard implan­tation technique have been described previously. The device is a hydrogel core-and-skirt keratoprosthesis that biointegrates through tissue growth into the peripheral white porous skirt. In this chapter, we present the standard and evolving surgical techniques used with AlphaCor and discusses patient management.