AIM: To evaluate the effectiveness and safety of intravitreal injection of ranibizumab combined with Ahmed drainage valve implantation compared to pure Ahmed drainage valve implantation in the treatment of NVG.

METHODS: Computers were used to search PubMed, EMbase, Cochrane Library, American Scientific Citation Index Database(SCI), China Knowledge Network(CNKI), Chinese Science and Technology Journal Database(VIP), Wanfang Database, China Biomedical Document Service System(CBM), and to find literature about ranibizumab and Ahmed drainage valve implantation in the treatment of NVG. At the same time, relevant references were consulted. The search time limit was establishment until March 20, 2020. Quality evaluation and data extraction on the included studies were performed. RevMan 5.3 and STATA 12.0 software were used for Meta-analysis.

RESULTS: The included 7 clinical studies included 346 patients(349 eyes), and the quality was evaluated as medium to high quality. The homogeneity of the basic characteristics of various studies was better. Compared with the pure Ahmed drainage valve implantation group(the control group), the ranibizumab combined with Ahmed drainage valve implantation group(the experimental group)had lower intraocular pressure at 1wk and 1mo after surgery. There was no statistical difference at 6mo after surgery. The BCVA of the experimental group was better than that of the control group at 1mo and 3mo, and there was no significant difference at 6mo after surgery. There was no significant difference in the rate of anterior chamber bleeding and the number of anti-glaucoma drugs used between the two groups.

CONCLUSION: Compared with pure Ahmed drainage valve implantation, ranibizumab combined with Ahmed drainage valve implantation has better postoperative intraocular pressure and best corrected visual acuity in the early stage in the treatment of NVG, and the difference in the late postoperative period is not significant. It cannot reduce the rate of postoperative anterior chamber bleeding, and cannot reduce the use of anti-glaucoma drugs. This conclusion needs to be further confirmed by more high-quality clinical randomized controlled studies.