Corneal Melt While Using Topical Bevacizumab Eye Drops.

A 75-year-old man presented with an idiopathic central corneal perforation and was treated with cyanoacrylate glue and a bandage contact lens. The stromal bed healed but the patient was left with 360 degrees of corneal neovascularization. Bevacizumab eye drops (25 mg/mL) were prescribed for 1 month which caused marked regression of the blood vessels. A penetrating keratoplasty was performed and the patient continued to use the bevacizumab eye drops for 6 weeks after surgery. The patient noted decreased visual acuity 5 weeks after surgery and was found to have a melt in the stroma of the donor graft necessitating repeating therapeutic penetrating keratoplasty and Gunderson flap. This case highlights that whereas topical bevacizumab may aid in regression of acute corneal neovascularization, caution should be employed with its use in patients with a history of corneal melt.