['To evaluate whether the vascular endothelial growth factor A (VEGF-A) in the recipient cornea measured at the time of penetrating keratoplasty (PK) can act as a prognostic factor for corneal graft reaction development.', 'The study included 25 eyes (of 25 patients) scheduled for PK. According to preoperative clinical finding, patients were divided into three groups: inflammatory with neovascularization (n\u2009=\u200911); inflammatory without neovascularization (n\u2009=\u20097); and non-inflammatory (n\u2009=\u20097). One half of the recipient cornea was analyzed for the levels of VEGF-A protein using a commercial enzyme-linked immunosorbent assay; the other half was analyzed to determine the loci of VEGF-A production by immunohistochemistry. The frequencies of corneal graft reaction and rejection were recorded, together with the improvement of visual acuity. Twenty-five donor corneas obtained from cadaver eyes represented the control group (n\u2009=\u200925).', 'There was a statistically significant difference in the levels of VEGF-A protein between the recipient corneal buttons obtained from eyes with inflammatory changes and neovascularization, and those from the non-inflammatory group and controls (p\u2009<\u20090.01). The level of VEGF-A was 287.74\u2009pg/ml (standard deviation [SD]\u2009=\u2009129.181) in the inflammatory with corneal neovascularization group, 227.64\u2009pg/ml (SD\u2009=\u200985.590) in the inflammatory without neovascularization group, 115.37\u2009pg/ml (SD\u2009=\u2009105.93) in the non-inflammatory group, and 142.28\u2009pg/ml (SD\u2009=\u200993.081) in the control group. Graft reaction/rejection rate was 54.5%/45.5% in the inflammatory with neovascularization group, 14.3%/0% in the inflammatory without neovascularization group, and 14.3%/14.3% in non-inflammatory group. Patients who developed clinical signs of graft reaction during the postoperative follow-up had a significantly higher level of VEGF-A (307.4\u2009pg/ml, SD\u2009=\u2009100.058) compared with those without any signs of graft reaction (182.8\u2009pg/ml, SD\u2009=\u2009124.987).'] Does vascular endothelial growth factor in a recipient cornea act as a prognostic factor for corneal graft reaction development?