Is the injection safe? Can it damage the eye?

Intravitreal injection is a well-established, mature procedure that is very safe when performed under strict aseptic conditions. The most serious complication is infectious endophthalmitis, with an incidence of approximately 1 in 3,000-5,000 injections. When recognized early and treated promptly (within 24-48 hours), most cases can be managed with preservation of useful vision. Other common mild reactions — subconjunctival hemorrhage, transient floaters, mild IOP rise — are self-limiting and require no treatment.

How many injections are needed? Is this a lifelong treatment?

Anti-VEGF therapy is often a long-term management strategy, but not every condition requires indefinite repeated injections. Wet AMD commonly needs prolonged treatment, while some entities such as myopic CNV may require fewer injections once controlled. Most protocols transition from an initial loading phase to a flexible PRN or treat-and-extend schedule based on OCT findings, and your physician will decide whether further injections are needed at each follow-up visit.

Will my vision improve after injections?

The primary goal of anti-VEGF treatment is to halt further vision loss and prevent disease progression. Approximately 30-40% of patients experience visual improvement, 40-50% maintain stable vision, and some patients — particularly with advanced disease — may still experience slow decline despite regular treatment. Earlier treatment, when macular architecture is better preserved, offers greater potential for visual recovery.

Treatment Procedure

Ophthalmic Surgery

Intravitreal Anti-VEGF Injection

Anti-VEGF Intravitreal InjectionRanibizumab / Aflibercept / Conbercept InjectionVEGF Inhibitor Eye Injection

Anti-vascular endothelial growth factor (VEGF) medication is precisely injected into the vitreous cavity to suppress pathological neovascularization and vascular leakage — the first-line treatment for wet AMD, diabetic macular edema, and retinal vein occlusion macular edema.

Intravitreal anti-VEGF injection is the gold-standard treatment for macular edema and choroidal neovascularization (CNV) caused by a range of retinal vascular diseases. VEGF is the key driver of pathological neovascularization and vascular hyperpermeability; anti-VEGF agents specifically bind VEGF, blocking its receptor interaction and thereby inhibiting new vessel growth, reducing vascular leakage and macular edema, and preserving or improving central vision. Currently approved agents include ranibizumab (Novartis; Lucentis), aflibercept (Bayer; Eylea; domestic biosimilars now available), bevacizumab (off-label), and conbercept (Chengdu Kanghong; Langmu — a Chinese-developed agent with a multi-VEGF-family binding profile). Drug choice depends on disease type, severity, required injection interval, and cost considerations. Intravitreal injection is an outpatient procedure performed under topical anesthesia with strict asepsis. A fine needle is inserted 3.5-4 mm posterior to the limbus (pars plana) and 0.05 mL of drug is delivered into the vitreous cavity. The procedure takes approximately 5 minutes; post-injection observation of 30-60 minutes confirms there is no acute IOP elevation before discharge.

Start Planning View Process Steps

Quick Reference

Treatment

5 mins – 15 mins

Observation

30 mins – 1 hours

Est. Cost

¥877.88 – ¥2,633.63

Department

Ophthalmology

5 mins – 15 minsDuration

¥877.88 – ¥2,633.63Cost

Who Is This For

Is Intravitreal Anti-VEGF Injection Right for You?

Good Candidates

Neovascular (wet) age-related macular degeneration (nAMD) with active CNV
Diabetic macular edema (DME) involving or threatening the center of the macula
Macular edema secondary to central or branch retinal vein occlusion (CRVO/BRVO)
Myopic CNV (pathologic myopia-associated choroidal neovascularization)
Other anti-VEGF indications (e.g., retinopathy of prematurity)

May Not Be Suitable

Active periocular or intraocular infection (injection must be deferred until infection is controlled)
Known hypersensitivity to the specific anti-VEGF agent or its components
Very low baseline IOP (hypotony may be worsened by injection)
Severe coagulation disorder (relative contraindication — risk-benefit must be assessed)
End-stage retinal disease with minimal residual visual function where meaningful benefit is unlikely

Step-by-Step Process

How Intravitreal Anti-VEGF Injection Works

Intravitreal Anti-VEGF Injection process

Preparation and Antisepsis

The patient lies supine. Topical anesthetic drops are instilled. The ocular surface is sterilized with 5% povidone-iodine (conjunctival sac irrigation + periocular skin preparation). Strict aseptic technique is maintained throughout to prevent infectious endophthalmitis. A lid speculum is placed.

Injection Site Marking

A caliper marks the injection site 3.5-4 mm posterior to the limbus in the inferotemporal quadrant (the preferred avascular zone). The planned needle trajectory is confirmed to be clear of the crystalline lens.

Intravitreal Drug Delivery

A 30-gauge needle is inserted perpendicular to the sclera at the marked site and advanced into the vitreous cavity. 0.05 mL (50 μL) of anti-VEGF drug is slowly injected over approximately 5-10 seconds. The needle is withdrawn and the puncture site gently compressed with a cotton tip.

Immediate Post-Injection Assessment

The optic disc is promptly visualized by indirect ophthalmoscopy or slit lamp to assess for pallor indicating acute ischemia from IOP spike. IOP is measured and confirmed within an acceptable range.

Observation and Discharge

The patient waits in the clinic for 30-60 minutes. A second IOP check and symptom inquiry are performed before discharge. Written aftercare instructions are provided, clearly describing the symptoms of endophthalmitis and emergency contact procedures.

Anti-VEGF injection is a long-term, chronic disease management strategy requiring repeated treatment. Common protocols include an initial loading phase (3 monthly injections), followed by a pro re nata (PRN) or treat-and-extend (T&E) maintenance phase with injection intervals adjusted based on OCT findings. Wet AMD patients average 4-8 injections per year; DME patients average 5-8, depending on disease stability.

Cost Information

Cost Estimate for Intravitreal Anti-VEGF Injection

Estimated Price Range

¥877.88 – ¥2,633.63

What's Included

Public tier-3A International Medical Department: imported drug (ranibizumab/aflibercept) approximately ¥6,000-10,000 per eye per injection; domestic conbercept approximately ¥4,500-7,000 per eye. Premium private eye centers: imported drug approximately ¥10,000-18,000 per injection, including comprehensive preoperative OCT assessment and follow-up management. Cost variation mainly stems from drug choice and service package.

Before Your Visit

What to Prepare

Required Tests & Examinations

If you already have recent valid test results, bring the reports. If not, these assessments can usually be completed in China before the procedure.

Macular OCT (structural assessment of retinal edema and CNV activity — the key monitoring tool)

Fundus fluorescein angiography (FFA) and/or indocyanine green angiography (ICGA — characterize CNV type and extent)

Best corrected visual acuity (BCVA — document baseline)

Color fundus photography (document lesion extent)

Intraocular pressure measurement

Systemic blood pressure and blood glucose (essential for diabetic patients)

Documents & Materials to Bring

Required to Bring

Recent macular OCT and fundus angiography reports

Systemic disease records (diabetes, hypertension, coagulation disorders)

Current medication list (especially anticoagulants)

Prior anti-VEGF injection history (drug name, number of injections, treatment response)

Passport and valid visa

Companion & Support

A companion is required on the injection day, as transient visual disturbance and occasional procedural anxiety may prevent the patient from traveling independently. For patients on frequent injection schedules, it is important that family members recognize the symptoms of endophthalmitis and know the emergency contact process.

After Treatment

Recovery & Follow-Up

Subconjunctival hemorrhage (red eye patch) is common, harmless, and resolves spontaneously within 1-2 weeks; mild foreign-body sensation and increased floaters from the medication bubble are also normal

Avoid water contact with the eye and do not rub the eye for 24 hours after injection

Seek emergency care immediately if eye pain worsens significantly, vision drops sharply, or discharge increases in the 3 days post-injection — these may signal infectious endophthalmitis (most serious complication; incidence ~1/3,000; outcomes are best with prompt treatment)

Tight systemic risk factor control (blood glucose, blood pressure) is critical to slowing disease progression

Adhere strictly to the follow-up schedule — do not self-discontinue treatment because vision appears temporarily stable

Follow-Up Schedule

OCT review is usually performed 4-8 weeks after each injection to assess macular edema resolution and CNV activity, determining whether the next injection is indicated. Most diseases require long-term follow-up, but the frequency and total treatment duration depend on diagnosis, lesion activity, and treatment response.

Related Conditions

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