The effect of prospective HLA-A and -B matching on corneal graft survival was studied in 159 Dutch recipients. The follow-up period ranges from 3 months to 4 1/2 years. In the same period 380 grafts were performed at random. The influence of HLA-A and -B matching on graft survival in all vascularized cases (n = 137) was significant (P = 0.046). If the non-immunological failures are excluded the effect of HLA-A and -B matchings becomes more pronounced (P = 0.027). The influence of HLA-A and -B matching on the graft survival of only the first grafts in vascularized corneas was more significant (p = 0.028). Finally a significant influence of HLA-A and -B matching was also found in repeated grafts in vascularized corneas (P = 0.037).