AIM:To quantitatively detect the diseased corneal epithelial cells, conjunctival cells before and after aqueous tear deficiency dry eye treatment by using corneal confocal microscope and conjunctival impression cytology, so as to further accurately evaluate the dry eye treatment outcome and prognosis. METHODS:There were 21 cases (41 eyes) which were clinically diagnosed as aqueous tear deficiency dry eye based on their history, symptoms, corneal and conjunctival signs and relevant examinations. All patients with dry eye were treated by polyethylene glycol eye drops combined with Carbopol gel. Based on conjunctival impression cytoscopy, squamous metaplasia and goblet cells number of conjunctival cells in dry eye patients were graded and the impression cells classification before and after treatment was statistically compared. Morphological change of nerve fibers under corneal epithelial before and after dry eye treatment was observed by using Heidelberg laser confocal microscopy. The changes of corneal epithelium cell density before and after treatment under peer conjunctival cells dryness were quantitatively evaluated. RESULTS:Impression cytoscopy: before treatment ≤ grade Ⅱ in 6 eyes, grade Ⅲ in 25 eyes, ≥grade Ⅳ in 10 eyes; 6 months after treatment ≤ grade Ⅱ in 19 eyes(463%), grade Ⅲ in 17 eyes(41.5%), ≥grade Ⅳ in 5 eyes（12.2%）. The proportion of patients with different levels of impression cells before and after treatment was significantly changed. Morphological changes under confocal microscopy: cell density decreased in cell necrosis exfoliated area of corneal epithelial before treatment; corneal subcutaneous nerve fibers appeared branch unorganized, abnormal strike line, no subcutaneous nerve fibers in 5 eyes. Regional cell density increased 6 months after treatment. All patients can seen subcutaneous nerve fibers, a small number of cases still appeared branch unorganized, abnormal strike line. Confocal microscopy showed under the conjunctival impression cytology degree at the same level, the corneal epithelial cell density before and after treatment were compared, there was statistically significant difference (P<0.05). The cell density was significantly increased after treatment. CONCLUSION: The aqueous tear deficiency dry eye treatment outcomes were quantitatively observed by using corneal confocal microscopy and conjunctival impression cytology in order to determine the significant value of above two methods in dry eye treatment evaluation.