Immediate Intraocular Pressure Dynamics Following Intravitreal Aflibercept, Ranibizumab and Faricimab: A Prospective Comparative Study

Dr Sumanth Tangudu

Abstract: Background / Aims: Intravitreal administration of anti?vascular endothelial growth factor agents is the cornerstone of treatment for common retinal vascular disorders. A transient rise in intraocular pressure (IOP) following injection is a recognised immediate effect, but the magnitude and pattern of this rise may vary among different agents. This study aimed to compare short-term post-injection IOP changes following intravitreal aflibercept, ranibizumab and faricimab. Methods: This prospective, observational study included 75 patients diagnosed with neovascular age-related macular degeneration or diabetic macular oedema. Patients were equally allocated into three groups receiving intravitreal aflibercept 2 mg, ranibizumab 0.5 mg or faricimab 6 mg. IOP was measured using a iCare IC200-tonometer prior to injection (T0) and at 30 seconds (T1), 5 minutes (T2) and 15 minutes (T3) following injection. Changes in IOP over time within each group and differences between treatment groups were analysed. Any occurrence of acute visual loss necessitating intervention was recorded. Results: A significant elevation in IOP was observed in all treatment groups at 30 seconds post-injection (T1). The mean IOP rise at T1 was highest in the aflibercept group (43.40 ? 9.80 mm Hg), followed by ranibizumab (42.20 ? 10.10 mm Hg), while faricimab demonstrated a comparatively lower initial increase (34.10 ? 8.60 mm Hg). By 5 minutes post-injection, IOP values declined substantially, with no statistically significant differences between the groups. At 15 minutes, mean IOP had returned to near-baseline levels in all eyes. No patient developed sustained visual impairment or required anterior chamber paracentesis. Conclusion: Intravitreal aflibercept, ranibizumab and faricimab are associated with a brief but marked rise in IOP immediately following injection, which resolves rapidly within 15 minutes. Faricimab produces a lower early IOP spike compared with aflibercept and ranibizumab; however, overall short-term IOP behaviour is comparable among the three agents.

Keywords: Intraocular pressure, Intravitreal injections, Anti-vascular endothelial growth factor, Aflibercept, Ranibizumab, Faricimab, Age-related macular degeneration, Diabetic macular oedema

How to Cite?: Dr Sumanth Tangudu, "Immediate Intraocular Pressure Dynamics Following Intravitreal Aflibercept, Ranibizumab and Faricimab: A Prospective Comparative Study", Volume 15 Issue 2, February 2026, International Journal of Science and Research (IJSR), Pages: 112-116, https://www.ijsr.net/getabstract.php?paperid=MR26129233703, DOI: https://dx.doi.org/10.21275/MR26129233703