Topical bevacizumab for corneal neovascularization after penetrating keratoplasty

To evaluate the efficacy of topical bevacizumab for corneal neovascularization in graft rejection.

A 55-year-old man presented with corneal neovascularization and graft rejection 6 months following penetrating keratoplasty (triple procedure) in the left eye. His best-corrected visual acuity (BCVA) was counting fingers at 1 meter. He was administered topical bevacizumab (4 mg/4 mL) in a dose of one drop twice a day for 15 days. No adjunct therapy was given during bevacizumab administration.

After 1 month, his BCVA improved to 20/120. Corneal vascularization and stromal haze regressed. After 6 months, his BCVA improved to 20/60 with further regression in corneal vascularization and stromal haze. At 9-month follow-up, he maintained BCVA of 20/60.

Short-term topical bevacizumab therapy may potentially offer a safer and more effective alternative in treating graft rejection after penetrating keratoplasty.