Bevacizumab (Avastin) and Argon Laser to Treat Neovascularization in Corneal Transplant Surgery

Purpose: Two eyes with corneal neovascularization were treated with argon laser and bevacizumab (Avastin) to enhance transplant survival after penetrating keratoplasty. Patients and Methods: Before penetrating keratoplasty, pathologic corneal vessels were treated with argon laser coagulation and a simultaneous, subconjunctival bevacizumab injection. Four to 6 weeks after this treatment, corneal transplantation was performed, followed by an intraocular injection of bevacizumab. Results: A marked reduction of corneal neovascularization was observed in both eyes after the combined argon laser coagulation and subconjunctival bevacizumab injection. No major bleeding from corneal vessels occurred during the recipients' cornea trephination. At the end of the transplantation, bevacizumab was injected into the anterior chamber, the posterior chamber, and subconjunctivally with-out any immediate side effects, No recurrence of pathologic vessels' spreading into the graft was observed. Both transplants have remained clear without signs of rejection for more than 6 months. Conclusions: The combination of argon laser coagulation and bevacizumab injections may be a promising tool in treatment of neovascularization in association with corneal transplant surgery. Antivascular endothelial growth factor substances may increasingly play a role in anterior segment surgery in the future.