Vis-à-Vis therapeutic keratopigmentation was performed in 184 blind eyes between 2016 and 2024 using inorganic or mixed pigments by different surgical approaches according to indication. The average time for corneal healing (re-epithelialization) was 14 days, with delayed healing occurring in less than 20% of patients. Postoperative complications included pigment fading, infectious keratitis, photophobia, and corneal melting, but mostly did not compromise the final cosmetic result. Some cases of MRI-related discomfort have occurred with iron oxide pigments, but without permanent structural changes. After long-term follow-up, 90% of the eyes were rated as good to excellent looking, and 88% of patients expressed high satisfaction with the improvement in psychosocial well-being. Keratopigmentation thus represents an effective reconstructive procedure that improves aesthetics and quality of life for blind patients.