中文摘要：

目的分析角膜移植术后病毒性角膜内皮炎的临床特征，指导临床诊断与治疗。方法对2008年1月至2012年10月在山东省眼科研究所收治的24例确诊为角膜移植术后内皮炎的病例进行回顾性分析。分别记录其裂隙灯显微镜下角膜水肿的位置、范围、内皮面KP情况，激光共聚焦显微镜（Confocal）下内皮细胞形态、数量及内皮面KP情况，总结其临床特征及治疗转归。结果裂隙灯显微镜可见角膜植片和（或）植床水肿，水肿对应的内皮面出现散在、斑块状KP，KP均匀分布于受累植片及植床；Conical下可见水肿对应植片与植床的内皮面均有多量炎症细胞浸润，内皮细胞水肿，失去六边形结构，边界模糊，细胞核增大；可见大小不一，形态各异的高反光KP，呈散在分布，聚集成团或条索状分布；可见暗区，暗区内细胞边界与细胞结构无法识别。应用抗病毒药物联合糖皮质激素治疗7-10d后，患者病情得以控制，视力较治疗前均有不同程度的提高。药物治疗3个月后与发病前相比较，内皮细胞丢失率为（9．9±2．1）％。结论角膜移植术后出现植片水肿和内皮面KP要考虑病毒性角膜内皮炎的可能性，掌握其临床特征，有利于诊断和治疗。

英文摘要：

Objective To summarize and analyze the clinical characteristics of viral corneal endo- theliitis after corneal transplantation, and providing clinic guidance for diagnosis and treatment. Methods Twenty-four clinical cases with corneal endermatitis after keratoplasty referred to our hospi- tal from January 2008 to October 2012 were retrospectively analyzed. Corneal edema, and the chang- es of endothelial surface KP were recorded under slit lamp microscope. The morphology and quanti- ty of endothelial cell, along with the changes of endothelial surface KP also were examined by the laser scanning confocal microscope. Results Slit lamp microscope examinations showed that the cor- neal edema of graft and/or planting bed, and appearing scattered and patchy KP under endothelial surface, moreover, KP evenly distributed in the affected graft and planting beds. Confocal images re- vealed that： cell edema, highly inflammatory cell infiltration, loss of defined hexagonal cell boundaries, enlarged nuclei; different sizes and shapes of high reflective and scattered KP, gathered into a mass or cords; the visible dark areas with blurry borders and cell structure. After 710 days treatment by antivi- ral therapy combined with glucocorticoids, the patients＇ condition was controlled, and vision were im- proved than before. After 3 months treatment, the loss of endothelial cell was （9.9±2.1）%. Conclu- sions It needs consider the possibility of corneal endotheliitis when appearing graft edema, the surface endothelial and the change of KP after corneal transplantation, and grasping the clinical features, which plays an important role in improving the diagnostic level in our clinical practicing work.