Conbercept

Neovascular glaucoma (NVG) is a vision-threatening condition commonly associated with uncontrolled intraocular pressure (IOP). Ahmed glaucoma valve (AGV) implantation and Ex-PRESS shunt insertion are 2 frequently applied surgical techniques. This study aimed to compare the short-term and 1-year outcomes of these procedures when combined with intravitreal conbercept therapy. Forty-four patients diagnosed with NVG were randomly allocated to either the AGV group (n = 24) or the Ex-PRESS group (n = 20). All participants received adjunctive intravitreal conbercept injections. Postoperative assessments (including IOP, best-corrected visual acuity, iris neovascularization regression, use of antiglaucoma medication, and complication rates) were conducted on day 1, week 1, and at 1, 3, 6, and 12 months. No significant difference in IOP reduction was observed between the 2 groups up to 6 months after surgery. At the 12-month follow-up, mean IOP was significantly lower in the AGV group (18.17 ± 4.41 mm Hg) compared with the Ex-PRESS group (21.60 ± 5.25 mm Hg; P  = .02). Improvements in best-corrected visual acuity, regression of iris neovascularization, and surgical success rates were comparable between the 2 groups during the early postoperative period. Nevertheless, AGV implantation showed a sustained advantage in long-term IOP control. Both AGV and Ex-PRESS implantation combined with conbercept provide effective and safe short-term management for NVG. Over a 1-year period, AGV implantation demonstrated better IOP control, indicating its potential benefit for long-term outcomes in NVG treatment.

Existing meta-analyses of anti-vascular endothelial growth factor therapies for neovascular age-related macular degeneration focus mainly on ranibizumab and aflibercept, with limited data on newer agents (faricimab, conbercept). This network meta-analysis (NMA) comprehensively compares all four key agents.

We systematically searched multiple databases for randomized controlled trials. Bayesian random-effects network meta-analysis was conducted, with evidence certainty assessed using CINeMA (Confidence in Network Meta-Analysis).

Thirty-nine randomized controlled trials involving 11,548 participants were included. For best-corrected visual acuity, agents showed comparable efficacy (high to moderate evidence); differences were neither statistically nor clinically significant. Choroidal neovascularization regression showed no important differences (mostly low certainty evidence). For retinal thickness, superior reductions versus ranibizumab 0.5 mg were observed with aflibercept 2 mg (MD: -14.27, 95 % CrI: -27.25, -1.75; high certainty), aflibercept 8 mg (MD: -32.43, 95 % CrI: -57.40, -7.75; high certainty), and conbercept 0.5 mg (MD: -10.26, 95 % CrI: -19.43, -0.98; moderate certainty). Faricimab required significantly fewer injections (high certainty evidence). Aflibercept 2 mg showed better ocular safety than faricimab 6 mg (OR: 0.58, 95 % CrI: 0.37, 0.90) and ranibizumab 0.5 mg (OR: 0.72, 95 % CrI: 0.53, 0.97; high certainty).

Aflibercept and conbercept may be preferred when anatomical outcomes are prioritized, whereas faricimab's extended dosing interval could benefit treatment-adherent populations. The superior safety profile of aflibercept 2 mg warrants consideration in risk averse patients. These differential effects support personalized therapeutic decision-making.