METHODS: This study was conducted as a retrospective, case series investigation. A total of 102 patients(102 eyes)diagnosed with NVG from Jan. 2019 to Feb. 2020 were enrolled and randomized to trabeculectomy group(50 eyes of 50 cases)or EX-PRESS drain implantation group(52 eyes of 52 cases)3-5d after conbercept injections. The concentrations of VEGF, IL-6 and IL-8 in aqueous humor were determined by enzyme-linked immunosorbent assay(ELISA). The therapeutic efficacies of different surgical modalities were evaluated and compared by status of iris neovascularization, changes in postoperative intraocular pressure(IOP), improvement of visual acuity and incidence of complications.

RESULTS:Decreases in aqueous humor concentrations of VEGF, IL-6 and IL-8 were observed at 3-5d after treatment of conbercept(all P<0.05). At 1, 3d, 1, 3, 6 and 12mo after surgery, the IOP levels of patients in both groups were significantly reduced compared to those before surgery(all P<0.05), and there was a statistically significant difference in IOP between the two groups at 3, 6, and 12mo postoperatively(all P<0.05). At 6 and 12mo after surgery, patients treated with EX-PRESS drain implantation showed better visual acuity compared to patients treated with trabeculectomy(all P<0.05). There was no statistically significant difference in types and dosages of anti-glaucoma drugs administered to patients in different groups. At 12mo follow-up, success rate of surgery in the EX-PRESS drain implantation group(86.5%)was higher than that in the trabeculectomy group(70.0%), along with remarkably lower incidence rate of complications compared to that of the trabeculectomy group(P<0.05).

CONCLUSION: The intravitreal injection of conbercept could down-regulate aqueous humor concentrations of VEGF, IL-6 and IL-8. Both of trabeculectomy and EX-PRESS drain implantation could reduce IOP in NVG patients, but the latter procedure had fewer incidence of complications and was more advantageous in improving visual acuity.