I'm gonna get this out of the way. I followed the drama involved with Afterbirth, so maybe my rating is completely bias here and I'm just salty over it all. With that said, my Afterbirth experience has been completely iffy since launch (a month before typing this) and has ruined some aspects of the game in my opinion.
Binding of Isaac: Rebirth is one of my all time favourite games. It is a heavily replayable, fun twist on two game styles that it shares it's gameplay from: Legend of Zelda-esque top down shooters, and roguelikes. Sure, there are things about the game that I don't like from a gameplay standpoint (mostly a few bosses that I think should be balanced better like The Adversary and The Bloat) but I have loved the game. I've dumped about 150 hours into Rebirth over the year it has been out. I have played it enough to where I have unlocked all the achievements except for the ones relating to The Lost (I got as far as completing The Womb as The Lost). I thought the original Isaac was an incredibly ambitious idea, that was held back by being programed in flash, and Rebirth was the perfect remake to reflect this ambition.
So why would I give Rebirth a perfect score, but Afterbirth a significantly lower score? Because I honestly think Edmund as gone way too far up his own ass here.
When people complain about Dark Souls 2 in comparison to Dark Souls, they often cite the fact that the game feels difficult for the sake of being difficult, instead of feeling difficult but fair. That totally applies here as well. There are so many rooms that are designed to just fuck up runs, as opposed to being hard, but overcomeable with practice. Hell, Ive been having more trouble with the womb floors more than any other floor lately because of rooms that seem designed to deal damage in the most absurdly bullshit ways. For example, first floor you can get a thin room with pride in it. I died in 5 seconds here as Eve, because pride decided to do a double bomb summon, and there was nowhere for me to dodge. Or how about how you can get fucked over by Krampus's Brimstone spin if he happens to be near a wall? These are only two of many examples I could use to illustrate this point. Sure, in Rebirth there was a few rooms like this, but it is absolutely ramped up to an unnecessary extreme here. Creative rooms that are challenging, but fun is one of Isaac's strongest points. It feels seriously lacking here in the worst ways.
Not only that, but the release was a total mess. The game came released unfinished and incredibly buggy, and stayed that way for a few days before it was fixed. These bugs were big enough that a large chunk of the items advertised were missing from the game completely. Instead of bug testing the game and releasing it later, it was released on October 30th; a date that correlates with it's themes. This is inexcusable for a game that feels as buggy as Afterbirth did on launch. Not only that, but every patch since then has released at least one major bug, while other major bugs have remained present since launch (1001% for example). Also, the nerfs to items is nothing short of absurd for a single player game like this. I'm still mad that The Stopwatch, an item that takes a long time to unlock and is pretty rare, was nerfed to the point where it is borderline useless. Things such as the Black Market glitch though remain within the game or items like Sackhead remain stupidly strong. It just adds more items to the unuseable pool, and makes the game feel like there are less ways to play.
Afterbirth is not all bad though. I do admit there are aspects I really like. The new item combos and transformations are great and always interesting. Greed mode, while not as good as the normal game, is still fun in it's own right. The Hush is a challenging, but rewarding boss to fight. These upsides are not without their downsides though, as Greed Mode turns into a stupidly long grind that I don't see myself doing despite wanting The Keeper, and The Hush feels misplaced and breaks the general pacing of the game overall.
Afterbirth does have some good ideas in it, but it has LOADS of downsides to the point where I'd advise waiting to play it until you've played Rebirth enough to where you need more content. Afterbirth feels like a total middle finger to the fans at some points, but if you are a hardcore Isaac fan, it is essentially required because of the better item combos, new bosses, new characters and the new items.
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This DLC was Edmunds attempt to make the game harder, as the biggest critique of Rebirth was it's easy difficulty in comparison to the original flash version of the game, so in Afterbirth with the addition of two new really cool characters and a fun Greed Mode the game seemed to be on an upward trend, but what also came with this update was a concerning amount of items that were built to be practically useless and that just flooded an item pool of fun items with items that ruin runs.
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I have to agree with PoisonYad, this DLC added an awful lot of bs level design to the game. Greed mode isn't very engaging either. Yakmang's review summarises things very well.
I'm extremely glad that I unlocked Keeper before the Glowing Hourglass fix/redesign. The fact that the Greed machine can jam is plain ridiculous when considering how much of a grind it is to fill the thing in the first place