目的:评价穿透性角膜移植(PK)手术眼科患者中,影响角膜植片存活和植片发生免疫排斥反应的临床因素。方法:回顾性分析解放军总医院眼科1993/2003年间,212例患者,224眼穿透性角膜移植手术的临床资料,以Kaplan-Meir’s方法计算其预期10a植片存活率及10a植片无免疫排斥存活率,对各因素水平间采用log-rank检验比较其差异,计算不同因素的相对危险度(RR),并采用Cox回归模型评价各因素对植片存活率的影响。结果:224眼总预期10a存活率和预期10a无免疫排斥存活率分别为81.4%和78.2%。与植片衰竭相关的高危因素包括角膜血管化、再次移植、无晶状体眼、人工晶状体眼、虹膜前粘连、虹膜后粘连、手术时间长(≥90min)和受者年龄大(≥60a)等。与植片发生免疫排斥反应相关的高危因素包括:角膜血管化和手术时间长(≥90min)。Cox回归模型显示只有角膜血管化(RR=2.46,P=0.04)、再次移植(RR=5.67,P<0.01)、无晶状体眼(RR=3.64,P< PURPOSE: To evaluate the clinical factors that affect the survival of corneal graft and the incidence of immunological rejection after penetrating keratoplasty (PK) surgery in ophthalmology patients. Methods: The clinical data of 212 patients and 224 eyes with penetrating keratoplasty during 1993/2003 were retrospectively analyzed. Kaplan-Meir’s method was used to calculate the expected survival rate of 10a and non-immune rejection of 10a The survival rates were calculated. The relative risk (RR) of different factors was calculated by log-rank test, and the effect of various factors on the survival rate was evaluated by Cox regression model. Results: The total expected survival rate of 10a and non-immune rejection survival of 10a for 224 eyes were 81.4% and 78.2% respectively. High risk factors related to graft failure include corneal vascularization, replantation, aphakia, intraocular lens, anterior synechia, posterior synechia, long duration of surgery (≥90 min), and older recipients (≥60 a). High risk factors associated with graft rejection include corneal vascularization and long duration of surgery (≥90 min). Cox regression model showed only corneal vascularization (RR = 2.46, P = 0.04), replantation (RR = 5.67, P <0.01)