AIM: To systematically evaluate the safety and efficacy of intravitreous injection of anti-VEGF drugs combined with Ahmed glaucoma drainage valve(AGV)implantation compared with single AGV implantation in the treatment of neovascular glaucoma(NVG).

METHODS: PubMed, Cochrane Library, American Science Citation Index(SCI)Database, China National Knowledge Infrastructure(CNKI), Wanfang Database were searched from the establishment to July 20, 2021 for relevant literatures about the treatment of NVG with AGV implantation and anti-VEGF drugs. These literatures were imported into EndNoteX9, strictly screened according to the inclusion and exclusion criteria and evaluated for their quality, and the raw data were extracted and integrated. STATA 16.0 and RevMan 5.3 were applied for Meta-analysis.

RESULTS: A total of 10 clinical studies with 490 eyes in total were included in Meta-analysis. According to the different research types of these literatures, the quality of the original literatures was evaluated as medium to high, and the homogeneity of the basic data among the studies was excellent. Meta-analysis showed that the intraocular pressure of patients who underwent intravitreous injection of anti-VEGF drugs was significantly decreased 1wk and 1mo after treatment compared with those patients who underwent single AGV implantation. Moreover, AGV implantation combined with intravitreous injection of anti-VEGF drugs could not improve postoperative best corrected visual acuity(BCVA). Although the combination with bevacizumab did not significantly improve the success rate of surgery, it could significantly reduce the amount of anti-glaucoma drugs still needed after surgery, whereas, ranibizumab did the opposite in both success rate and drug amount.

CONCLUSION: Compared with single AGV implantation, the combination of AGV implantation and intravitreous injection of anti-VEGF drugs has advantages in reducing intraocular pressure of NVG patients. According to different anti-VEGF drugs, the combination has some positive effects on increasing the success rate of surgery and reducing the amount of anti-glaucoma drugs still needed after operation.