Objective. To identify the main reasons influencing the effectiveness of eye prosthetics in patients with congenital anophthalmos. Material and methods. A total of 237 (two hundred and thirty-seven) patients with congenital anophthalmos were under observation: 108 boys (45.6% of patients) and 129 girls (54.4% of patients), bilateral process was observed in 14 patients. All patients applied to «Eye Prosthetics Centre», Moscow, during the period from September 2020 to November 2024. The age of the patients ranged from 1 month to 18 years (mean 8.0±6.43 years). The condition of the arch of the eyelids, conjunctival cavity configuration was assessed. Methods of external examination of the eyelids, eye slit, biomicroscopy of the conjunctival cavity and the surface of the ocular prosthesis were used to assess the cosmetic and therapeutic results. Photofixation was performed for dynamic control of external parameters and evaluation of the efficiency of ocular prosthetics. Results. Satisfactory and unsatisfactory cosmetic and therapeutic results in patients of different ages with congenital anophthalmos were analysed. The best results were achieved in children with correctly chosen tactics and early primary prosthetics, with further observance of the terms of scheduled replacements, methods of cavity and prosthesis care and absence of inflammatory diseases of conjunctiva. Conclusions. The main method of rehabilitation of patients with congenital anophthalmos is staged ocular prosthetics. This tactics allows to achieve high therapeutic, prophylactic and cosmetic results. It is recommended to make individual prostheses, which are correctly located in the conjunctival cavity, fill the arch of the eyelids and perfectly transmit color of the sclera, iris and pattern of the healthy eye, contribute to relieving the child from psychological trauma, creating conditions for normal adaptation in the family and community. © 2025 Elsevier B.V., All rights reserved.