Clinical observation on the features of corneal endotheliitis after corneal transplantation

Abstract

Objective To summarize and analyze the clinical characteristics of viral corneal endotheliitis after corneal transplantation,and providing clinic guidance for diagnosis and treatment.Methods Twenty-four clinical cases with comeal endermatitis after keratoplasty referred to our hospital from January 2008 to October 2012 were retrospectively analyzed.Corneal edema,and the changes of endothelial surface KP were recorded under slit lamp microscope.The morphology and quantity 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 corneal 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 revealed 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 antiviral therapy combined with glucocorticoids,the patients' condition was controlled,and vision were improved than before.After 3 months treatment,the loss of endothelial cell was (9.9±2.1)％.Conclusions 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. Key words: Corneal transplantation; Corneal endotheliitis; Slit lamp microscope; Confocal microscope