To assess in vivo corneal endothelial changes occurring over a six-month period after the intravitreal injection of bevacizumab (Avastin; Genentech Inc, San Francisco, California, USA) in patients with various macular diseases.

Prospective case series.

A total of 50 eyes from 50 consecutive patients received an intravitreal injection of 2.5 mg intravitreal bevacizumab. Specular microscopy, including central corneal thickness (CCT) and endothelial cell count, was performed on each patient for both eyes before injection and one day, seven days, three months, and six months after injection. The CCT at one and seven days was measured to evaluate the acute corneal endothelial damage; endothelial cell count at three and six months was used to estimate chronic corneal endothelial change.

All patients completed six months of follow-up. There was no significant difference in corneal thickness change between treated and nontreated eyes before injection or one and seven days after injection (P = .53, .34, and .87, respectively). There was also no difference in the treated eyes before injection and one and seven days after injection (P = .94). Long-term evaluation revealed that there was no significant difference in the corneal endothelial cell density of treated and nontreated eyes before injection and at three and six months after injection (P = .76, .13, and .22, respectively). There was also no difference in the treated eyes before injection and at three and six months after injection (P = .73).

The intravitreal injection of 2.5 mg bevacizumab seemed to have no harmful effects on the corneal endothelium.