Currently, it is estimated that 10 million patients diagnosed with bilateral corneal blindness suffer from corneal diseases worldwide. Eye Bank Associations show that corneal transplantation is highly successful in low-risk patients with corneal blindness, but often fails in those with high-risk indications, such as recurrent or chronic inflammatory disorders, a history of glaucoma and herpetic infections, and those with neovascularization of the host bed. Therefore, artificial and biomimetic corneas have been investigated for patients with indications that lead to keratoplasty failure. Certain biomolecules, such as collagen, can be used as a basis for bio-inks in 3D corneal bioprinting. Alternatively, xenogeneic decellularized corneas have shown potential in preserving the fibrillar architecture. This review discusses the possibility of broadening the spectrum of corneal transplantation with the future use of synthetic keratoprostheses and the limits of keratoplasty in the Republic of Moldova. In recent years, advancements in tissue engineering and regenerative medicine have provided innovative solutions for restoring corneal function. These include decellularized xenografts, bioengineered collagen scaffolds, and advanced preservation techniques that aim to maintain tissue viability and integrity. Research efforts are increasingly focused on improving biointegration, minimizing immune rejection, and enhancing optical clarity. Moreover, emerging technologies such as stem cell therapy and nanomaterials offer new perspectives in corneal repair and regeneration. The integration of these novel approaches may revolutionize treatment for corneal blindness and expand access to effective care, particularly in countries with limited donor tissue availability.