Safety and Efficacy of Bevacizumab in High-Risk Corneal Transplant Survival

Inclusion Criteria: * Age \> 18 years * Patient or legally authorized representative willing and able to provide written informed consent * Willing and able to comply with study assessments for the full duration of the study * High-risk characteristics for penetrating keratoplasty: Either presence of 1.) Corneal NV in one or more quadrants (≥ 3 clock hours NV ≥ 2mm from the limbus) OR 2.) Extension of corneal NV to graft-host junction in a previous failed graft * In generally good stable overall health Exclusion Criteria: * History of Stevens-Johnson syndrome or ocular pemphigoid * Ocular or periocular malignancy * Non-healing epithelial defect of at least 0.5x0.5 mm in host corneal bed lasting ≥6 weeks preoperatively * Uncontrolled glaucoma * Currently on dialysis * Has received treatment with anti-VEGF agents (intraocular or systemic) within 45 days of study entry * Concurrent use of systemic anti-VEGF agents * Change in topical corticosteroid regimen within 14 days of transplantation * Use of systemic immunosuppressive for indication other than corneal graft rejection * Pregnancy (positive pregnancy test) or lactating * Pre-menopausal women not using adequate contraception (Reliable intrauterine devices, hormonal contraception or a spermicide in combination with a barrier method) * Uncontrolled hypertension defined as systolic blood pressure (BP) ≥150 or diastolic BP ≥90 mmHg * History of thromboembolic event within 12 months prior to study entry * Participation in another simultaneous medical investigation or trial