Objective To compare the clinical efficacy and safety of ranibizumab and conbercept in the treatment of Pseudophakic cystoid macular edema. Methods This prospective randomized controlled study included 126 patients with Pseudophakic cystoid macular edema, who were randomly assigned to either the ranibizumab group (n=63) or the conbercept group (n=63). Patients in the two groups received intravitreal injections of 0.5 mg/0.05 mL ranibizumab or conbercept respectively over a treatment period of 3 months. Evaluation indicators included clinical efficacy, intraocular pressure (IOP), central foveal retinal thickness (CFT), corneal nerve fiber density and length, as well as the incidence of adverse reactions. Results There was no significant difference in clinical efficacy between the two groups (P ＞ 0.05). Both groups showed a significant reduction in IOP and CFT after treatment (P ＜ 0.001), with no statistically significant differences between the groups. The conbercept group exhibited a significant decrease in corneal nerve fiber length (P ＜ 0.001), whereas no significant changes were observed in the ranibizumab group; a significant difference between the groups was noted after treatment (P ＜ 0.001). The incidence of adverse reactions was low in both groups, with no statistical difference (P ＞ 0.05). Conclusions Both ranibizumab and conbercept demonstrate good clinical efficacy and safety in the treatment of Pseudophakic cystoid macular edema. Ranibizumab may offer advantages in preserving corneal nerve fibers; however, further research is needed to confirm this finding.