Two groups of patients were assigned randomly to treatment with epidermal growth factor or placebo after penetrating keratoplasty. In all cases, the epithelium was removed completely from the graft by scrubbing at the close of surgery. One group of patients received topically applied growth factor or placebo in a solution with preservative solution four times a day on the day of surgery and twice a day for two days thereafter. The second group of patients received one-half the concentration of growth factor or placebo in a solution without preservative eight times a day for four days beginning the day before surgery. Healing was assessed twice a day by color photography after instillation of 2% fluorescein; the percent area of the remaining epithelial defect was determined with a planimeter. No therapeutic benefit was demonstrated in the eyes treated with growth factor in either group of patients.