Background <p>To investigate changes in ocular and periocular tissue elasticity using shear wave elastography (SWE) in eyes with diabetic retinopathy following intravitreal aflibercept injections, and to compare these findings with those of the untreated contralateral eyes.</p> Methods <p>This prospective study included 42 eyes from 21 patients (11 males and 10 females; mean age: 65.9 ± 5.0 years) diagnosed with type 2 diabetic retinopathy. The effected eyes of the patients underwent intravitreal aflibercept injection therapy. SWE was performed on both injected and contralateral eyes at baseline, on day 1, and one month post-injection, measuring the elasticity of the crystalline lens(CL), posterior vitreous (PV), optic disc head (ODH), and retrobulbar fat (RF). Changes in the injected eyes were analyzed over time and compared with those in the untreated contralateral eyes.</p> Results <p>No statistically significant differences were found in the SWE values of the CL, PV, ODH, and RF between the injected and non-injected eyes at day 1 and one month post-injection (<i>p</i> &gt; 0.05). Additionally, no significant changes were observed in the SWE values of the injected eyes across the baseline, day 1, and one-month post-injection (<i>p</i> &gt; 0.05).</p> Conclusions <p>A single intravitreal aflibercept injection does not significantly affect the elasticity of ocular and periocular structures as assessed by SWE.</p> Clinical trial number <p>Not applicable.</p>