Combined treatment with Anti-Vegf and Perforating Keratoplasty in Neovascularized Corneas

Abstract Purpose:to study the efficacy of a surgical and pharmacological combined treatment in high-risk failure perforating keratoplasty (PKP) Methods:10 eyes of 10 patients with pre-exhisting corneal neovascularization due to different corneal pathologies, and mean visual acuity lower than 0.69 LogMAR (min 1.3 to max 0.39 LogMAR) were treated using a combined approach: perforating keratoplasty and Anti-Vegf administration. 0.5 ml bevacizumab injections were performed into four subconjunctival spaces using a 20 G needle. No further injections were made during 1 year follow up that was once a day for the first week, once a week for the first month and once a month for the first year. During follow up we focused our attention on (eventuale) neovessels growth and on patients’ visual acuity Results:10 ± 3 days after surgical treatments, all 10 eyes showed a complete regression of pre-exhisting host corneal neovessels. During follow-up time no signs of graft rejections or corneal neovascularization were noticed. In the observed cases, visual acuity improved from 0.69 to 0.3 LogMAR, with a mean improvement of 0.39 LogMAR Conclusions:according to our experience, with the combined approach we observed a complete regression of pre-exhisting corneal neovascularization. Moreover, the treatment prevented from neovessels growth after keratoplasty all follow-up time long. This approach could reduce graft-failure possibility also for corneal transplantations described in literature as "high-risk keratoplasties