ReviewGraefe's archive for clinical and experimental ophthalmology = Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie2026
Ranibizumab port delivery system for neovascular age-related macular degeneration: Current evidence and surgical considerations.
Review in Graefe's archive for clinical and experimental ophthalmology = Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Authors and funding
7 authors.
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Abstract
purposeTo review the engineering principles, pharmacokinetics, clinical evidence, surgical considerations, safety profile, and emerging real-world implications of the ranibizumab Port Delivery System (PDS) as a sustained intraocular drug-delivery platform for neovascular age-related macular degeneration.
methodsA systematic literature search was conducted to identify peer-reviewed publications addressing implant engineering, molecular compatibility, pharmacokinetics, phase 1-3 trials (LADDER, ARCHWAY, PORTAL), extension studies, perioperative management, safety outcomes, health-economic analyses, and patient-reported outcomes related to the ranibizumab PDS.
resultsPhase 2 and 3 trials demonstrated that PDS delivering ranibizumab 100 mg/mL with fixed 24-week refill intervals achieved visual and anatomic outcomes noninferior to monthly intravitreal injections, with approximately 95% of patients not requiring supplemental treatment before scheduled refills. Pharmacokinetic studies confirmed sustained intraocular drug exposure within the therapeutic window of monthly dosing. Long-term extension data support durability through multi-year follow-up. The distinct safety profile features implant- and conjunctival interface events, including conjunctival erosion, vitreous hemorrhage, and device-associated endophthalmitis, underscoring the importance of surgical technique and postoperative surveillance. Economic analyses indicate cost parity with branded anti-VEGF agents under high injection frequencies, while patient-reported outcomes consistently demonstrate strong preference for sustained delivery. In ARCHWAY, mean BCVA change averaged over Weeks 36/40 was + 0.2 letters with PDS versus + 0.5 letters with monthly ranibizumab, and 98.4% of PDS-treated eyes required no supplemental injections in the first 24-week interval; across later intervals, approximately 95% avoided supplemental treatment before scheduled refill.
conclusionsThe ranibizumab PDS establishes sustained intraocular anti-VEGF delivery as a viable alternative to anti-VEGF injections especially in patients requiring frequent dosing. Its long-term role will depend on optimization of surgical workflows, management of implant-specific risks, integration of monitoring strategies, and ongoing refinement of device design to support scalable, durable retinal care.
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42776254What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.