Endothelial rejection of human corneal allograft under confocal microscope

Objective:To observe and analyze the early morphologic characteristics and varieties of the enothelium of human corneal allograft in the endothelial rejection by in vivo confocal microscope. Methods:19 patients (19 eyes) with endothelial rejection of allograft after penetrating keratoplasty were devided into three groups according to the degree of rejection and examined by confocal microscopy (Confoscan 2.0)and slit-lamp biomicroscopy.The related factors of the results were analyzed. Results:The characteristics of the changes in endothelium during rejection by confocal microscope were as following.Near the KP in slight endothelial rejection, there were few of immune cells on the endothelium,slight stromal edema,the edema keratocytes represented the blur bubble area and arranged disorder.In moderate endothelial rejection,on the endothelium there were many immune cells accumulated that were activated completely.The edema of stromal cell was frank,the nuclei were not distinct,and some immune cells went into the stroma.The Khodadoust′s line were composed of the high reflective immune cells and cell fragments.In severe endothelial rejection,there were a lot of the activated immune cells accumulated on the endothelium.The endotheial cells were destroyed.The stroma was edema obviously and some keratocytes were activated.Some immune cells went into the stroma. Conclusions:There were few of immune cells on the endothelium in the slight endothelial rejection.There were affinitive correlation between endothelial rejection and immune cells.The endothelial rejection was exactly a mixed rejection by the confocal microscope.