{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T05:02:58Z","timestamp":1789448578548,"version":"build-2803163510"},"reference-count":29,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T00:00:00Z","timestamp":1789430400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Physiol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Intractable neovascular glaucoma (NVG), secondary to retinal ischemia, responds poorly to traditional surgery due to postoperative neovascularization and scarring. Intravitreal ranibizumab(IVR) swiftly alleviates neovascularization to enable subsequent treatment, yet its long-term efficacy remains unclear.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>This study sought to evaluate the ranibizumab-surgery combination therapy in NVG and describe clinical characteristics of surgical failure cases.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This retrospective propensity score matching (PSM) cohort study enrolled 62 patients (62 eyes) with NVG between August 2022 and August 2024. Using 1:1 nearest-neighbor PSM, 31 eyes received preoperative IVR plus conventional surgery (study group), while 31 underwent surgery alone (control group). Over 12 months of follow-up, the primary endpoint was the 12-month surgical success rate; secondary outcomes included IOP, BCVA, postoperative NVI status, and complications. IOP and BCVA were analyzed using linear mixed-effects models, and clinical characteristics of the failure cases were described descriptively.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>After PSM, baseline characteristics were generally comparable between groups, with residual imbalances noted for glaucoma stage and angle status. The study group showed significantly lower IOP at all postoperative visits (P &amp;lt; 0.05). The 12-month surgical success rate was numerically higher in the study group (93.5% vs. 77.4%). Secondary outcomes, including BCVA improvement and favorable NVI-free status, were more favorable in the study group, while the difference in overall complications did not reach statistical significance. Among the 9 failure cases, the majority had poor baseline BCVA, diabetes mellitus, and advanced glaucoma stage.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In this retrospective matched cohort, adjunctive IVR was associated with more favorable IOP control and NVI-free status, whereas the difference in the 12-month surgical success rate, although numerically higher, did not reach statistical significance. Given the exploratory nature of this single-center study, larger prospective studies are warranted to confirm these findings.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Significance and innovation<\/jats:title>\n                    <jats:p>This retrospective matched cohort study suggests that perioperative ranibizumab may be associated with more favorable IOP control and NVI-free status, although the 12-month surgical success rate did not reach statistical significance. These findings are exploratory and require confirmation in larger prospective studies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fphys.2026.1915879","type":"journal-article","created":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T04:27:11Z","timestamp":1789446431000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Intravitreal ranibizumab as an adjunct to conventional surgery for neovascular glaucoma: a retrospective observational study of efficacy and clinical characteristics of surgical failure cases"],"prefix":"10.3389","volume":"17","author":[{"given":"Dan","family":"Li","sequence":"first","affiliation":[{"name":"Department of Ophthalmology, Suzhou Kowloon Hospital Shanghai Jiao Tong University School of Medicine","place":["Suzhou, Jiangsu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chao","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Suzhou Kowloon Hospital Shanghai Jiao Tong University School of Medicine","place":["Suzhou, Jiangsu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qing","family":"Ye","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Suzhou Kowloon Hospital Shanghai Jiao Tong University School of Medicine","place":["Suzhou, Jiangsu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,9,15]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"1938","DOI":"10.1002\/jcb.30344","article-title":"Molecular mechanism of VEGF and its role in pathological angiogenesis","volume":"123","author":"Ahmad","year":"2022","journal-title":"J. Cell. Biochem."},{"key":"B2","doi-asserted-by":"publisher","first-page":"47","DOI":"10.63623\/8cv4gh26","article-title":"A scoping review on recent advances in antidiabetic medications: FromGLP-1 receptor agonists to dual and triple agonists","volume":"2","author":"Aktas","year":"2025","journal-title":"Adv. Clin. Pharmacol. Ther."},{"key":"B3","doi-asserted-by":"publisher","first-page":"315","DOI":"10.22336\/rjo.2021.66","article-title":"A review of neovascular glaucoma. Etiopathogenesis and treatment","volume":"65","author":"Dumbr\u0103veanu","year":"2021","journal-title":"Rom. J. Ophthalmol."},{"key":"B4","doi-asserted-by":"publisher","first-page":"308","DOI":"10.1097\/apo.0000000000000248","article-title":"Intravitreal Ranibizumab with panretinal photocoagulation followed by trabeculectomy versus visco-trabeculotomy in management of neovascular glaucoma","volume":"8","author":"Elwehidy","year":"2019","journal-title":"Asia Pac. J. Ophthalmol. (Phila)"},{"key":"B5","doi-asserted-by":"publisher","first-page":"395","DOI":"10.1080\/15569527.2019.1650060","article-title":"Needling with 5-fluorouracil for encapsulated blebs after Ahmed glaucoma valve implantation","volume":"38","author":"Erdem","year":"2019","journal-title":"Cutan Ocul. Toxicol."},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.1167\/tvst.5.2.10","article-title":"VEGF and intraocular neovascularization: From discovery to therapy","volume":"5","author":"Ferrara","year":"2016","journal-title":"Transl. Vis. Sci. Technol."},{"key":"B7","doi-asserted-by":"publisher","first-page":"18","DOI":"10.3390\/jpm14010018","article-title":"Clinical efficacy of preoperative and intraoperative intravitreal ranibizumab as adjuvant therapy of Ahmed glaucoma valve implantation combined with vitrectomy in the management of neovascular glaucoma with diabetic vitreous hemorrhage","volume":"14","author":"Gao","year":"2023","journal-title":"J. Pers. Med."},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.3389\/fmed.2024.1405261","article-title":"The efficacy and safety of anti-vascular endothelial growth factor combined with Ahmed glaucoma valve implantation in the treatment of neovascular glaucoma: a systematic review and meta-analysis","volume":"11","author":"He","year":"2024","journal-title":"Front. Med. (Lausanne)"},{"key":"B9","doi-asserted-by":"publisher","DOI":"10.1097\/md.0000000000008350","article-title":"Clinical efficacy analysis of Ahmed glaucoma valve implantation in neovascular glaucoma and influencing factors: A STROBE-compliant article","volume":"96","author":"He","year":"2017","journal-title":"Med. (Baltimore)"},{"key":"B10","doi-asserted-by":"publisher","first-page":"672","DOI":"10.1016\/j.ogla.2022.05.003","article-title":"Comparing surgical outcomes in neovascular glaucoma between tube and trabeculectomy: A multicenter study","volume":"5","author":"Iwasaki","year":"2022","journal-title":"Ophthalmol. Glaucoma"},{"key":"B11","doi-asserted-by":"publisher","first-page":"2116","DOI":"10.18240\/ijo.2025.11.13","article-title":"Treatment results switching from aflibercept to bevacizumab in wet age-related macular degeneration","volume":"18","author":"Kananen","year":"2025","journal-title":"Int. J. Ophthalmol."},{"key":"B12","doi-asserted-by":"publisher","first-page":"643","DOI":"10.1186\/s12886-025-04496-9","article-title":"Potential sustained benefits of early targeted panretinal photocoagulation in combination with anti-VEGF in macular edema secondary to retinal vein occlusion: 48-month results of a retrospective comparative study","volume":"25","author":"Kilani","year":"2025","journal-title":"BMC Ophthalmol."},{"key":"B13","doi-asserted-by":"publisher","first-page":"2757","DOI":"10.1007\/s10792-022-02265-x","article-title":"Clinical observation of ranibizumab combined with surgery in the treatment of neovascular glaucoma with vitreous hemorrhage","volume":"42","author":"Li","year":"2022","journal-title":"Int. Ophthalmol."},{"key":"B14","doi-asserted-by":"publisher","first-page":"65","DOI":"10.1186\/s12886-016-0248-7","article-title":"Intravitreal ranibizumab injection combined trabeculectomy versus Ahmed valve surgery in the treatment of neovascular glaucoma: assessment of efficacy and complications","volume":"16","author":"Liu","year":"2016","journal-title":"BMC Ophthalmol."},{"key":"B15","doi-asserted-by":"publisher","first-page":"2403","DOI":"10.1007\/s00417-013-2428-y","article-title":"Ranibizumab as adjuvant in the treatment of rubeosis iridis and neovascular glaucoma--results from a prospective interventional case series","volume":"251","author":"L\u00fcke","year":"2013","journal-title":"Graefes Arch. Clin. Exp. Ophthalmol."},{"key":"B16","article-title":"Guidelines","volume-title":"Glaucoma: Diagnosis and Management","year":"2022"},{"key":"B17","doi-asserted-by":"publisher","first-page":"S254","DOI":"10.4103\/ijo.ijo_3145_23","article-title":"Long-term outcome of surgical management in neovascular glaucoma: A retrospective, multicentric study","volume":"73","author":"Pegu","year":"2025","journal-title":"Indian J. Ophthalmol."},{"key":"B18","doi-asserted-by":"publisher","first-page":"19","DOI":"10.4103\/dljo.dljo_56_23","article-title":"Clinical profile and management of neovascular glaucoma in North India","volume":"32","author":"Rajurkar","year":"2022","journal-title":"Delhi J. Ophthalmol."},{"key":"B19","doi-asserted-by":"publisher","first-page":"477","DOI":"10.1007\/s00417-022-05785-5","article-title":"A systematic review and meta-analysis of randomised controlled trials in the management of neovascular glaucoma: absence of consensus and variability in practice","volume":"261","author":"Ramji","year":"2023","journal-title":"Graefes Arch. Clin. Exp. Ophthalmol."},{"key":"B20","doi-asserted-by":"publisher","first-page":"434","DOI":"10.1097\/icu.0000000000001151","article-title":"Medical and surgical management of neovascular glaucoma","volume":"36","author":"Santina","year":"2025","journal-title":"Curr. Opin. Ophthalmol."},{"key":"B21","doi-asserted-by":"publisher","first-page":"605","DOI":"10.1007\/s12288-019-01138-1","article-title":"T-Cell acute lymphoblastic leukemia with massive vitreo-retinal infiltration and neovascular glaucoma","volume":"35","author":"Selvan","year":"2019","journal-title":"Indian J. Hematol. Blood Transfus."},{"key":"B22","doi-asserted-by":"publisher","first-page":"1079","DOI":"10.1007\/s00417-019-04256-8","article-title":"Surgical treatment of neovascular glaucoma: a systematic review and meta-analysis","volume":"257","author":"Shchomak","year":"2019","journal-title":"Graefes Arch. Clin. Exp. Ophthalmol."},{"key":"B23","doi-asserted-by":"publisher","first-page":"400","DOI":"10.7150\/ijms.35267","article-title":"Efficacy and safety of intravitreal ranibizumab with panretinal photocoagulation followed by trabeculectomy compared with Ahmed glaucoma valve implantation in neovascular glaucoma","volume":"10","author":"Sun","year":"2017","journal-title":"Int. J. Ophthalmol."},{"key":"B24","doi-asserted-by":"publisher","first-page":"35","DOI":"10.25040\/aml2024.1-2.035","article-title":"The role of anti-VEGF therapy in improving the efficacy of surgical treatment of secondary neovascular glaucoma","volume":"30","author":"Sydorchuk","year":"2024","journal-title":"Acta Med. Leopoliensia"},{"key":"B25","doi-asserted-by":"publisher","first-page":"1870","DOI":"10.3390\/medicina58121870","article-title":"A review of neovascular glaucoma: Etiology, pathogenesis, diagnosis, and treatment","volume":"58","author":"Urbonavi\u010di\u016bt\u0117","year":"2022","journal-title":"Med. (Kaunas)"},{"key":"B26","doi-asserted-by":"publisher","first-page":"1412","DOI":"10.4103\/ijo.ijo_841_25","article-title":"Updates in the treatment of neovascular glaucoma: From conventional approaches to novel therapies","volume":"73","author":"Verma","year":"2025","journal-title":"Indian J. Ophthalmol."},{"key":"B27","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2023-080103","article-title":"Comparative efficacy and safety of different anti-VEGF agents combined with different delivery methods for neovascular glaucoma: a systematic review and Bayesian network meta-analysis","volume":"14","author":"Wang","year":"2024","journal-title":"BMJ Open"},{"key":"B28","doi-asserted-by":"publisher","first-page":"624","DOI":"10.3980\/j.issn.1672-5123.2023.4.18","article-title":"Meta-analysis of the efficacy of intravitreal Ranibizumab combined with compound trabeculectomy and panretinal photocoagulation in the treatment of neovascular glaucoma","volume":"23","author":"Zhao","year":"2023","journal-title":"Guoji Yanke Zazhi(Int. Eye Sci)"},{"key":"B29","doi-asserted-by":"publisher","first-page":"997","DOI":"10.3980\/j.issn.1672-5123.2022.6.22","article-title":"Clinical therapeutic effects of Aflibercept or Ranibizumab combined with Ahmed glaucoma valve implantation on neovascular glaucoma","volume":"22","author":"Zhou","year":"2022","journal-title":"Int. Eye Sci."}],"container-title":["Frontiers in Physiology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fphys.2026.1915879\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T04:27:15Z","timestamp":1789446435000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fphys.2026.1915879\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,15]]},"references-count":29,"alternative-id":["10.3389\/fphys.2026.1915879"],"URL":"https:\/\/doi.org\/10.3389\/fphys.2026.1915879","relation":{},"ISSN":["1664-042X"],"issn-type":[{"value":"1664-042X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,15]]},"article-number":"1915879"}}