Endothelial keratoplasty is a surgery that selectively replaces the diseased endothelium and reserves the normal corneal epithelial and stromal layers. It is now gradually replacing penetrating keratoplasty in treating endothelial dysfunction. Although endothelial cell loss exists after endothelial keratoplasty, the number of lost cells is obviously less than that of penetrating keratoplasty. The amount and function of corneal endothelial cells are important factors for maintaining corneal transparency and indicating the survival of the graft. Thus, the changes of corneal endothelial cell density after surgery are significant in predicting the prognosis. This article elaborates on the changes of endothelial cell density after endothelial keratoplasty and related influencing factors, aiming to provide reference and basis for clinical diagnosis and treatment. (Chin J Ophthalmol, 2018, 54:954-960).角膜内皮移植术是一种选择性置换病变的角膜内皮,同时保留正常的角膜上皮和基质层的手术,目前已逐渐取代穿透性角膜移植术而被广泛用于治疗角膜内皮功能失代偿。角膜内皮移植术后内皮细胞丢失数量明显少于穿透性角膜移植术。角膜内皮细胞数量和功能是维持角膜透明及提示植片存活的重要因素,因此术后内皮细胞密度的变化对预测预后具有重要意义。本文在总结角膜内皮移植术的基础上,详细阐述术后内皮细胞密度的变化及其影响因素,以期为临床诊疗工作提供参考和依据。(中华眼科杂志,2018,54:954-960).