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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 +\u20090.2 letters with PDS versus +\u20090.5 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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The 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.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00417-026-07519-3","type":"journal-article","created":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T06:12:03Z","timestamp":1790143923000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Ranibizumab port delivery system for neovascular age-related macular degeneration: Current evidence and surgical considerations"],"prefix":"10.1007","author":[{"given":"Alberto","family":"Quarta","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sobha","family":"Sivaprasad","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tien Y.","family":"Wong","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paolo","family":"Lanzetta","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charles C.","family":"Wykoff","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rodolfo","family":"Mastropasqua","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Srinivas R.","family":"Sadda","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,9,23]]},"reference":[{"issue":"10153","key":"7519_CR1","doi-asserted-by":"publisher","first-page":"1147","DOI":"10.1016\/S0140-6736(18)31550-2","volume":"392","author":"P Mitchell","year":"2018","unstructured":"Mitchell P, Liew G, Gopinath B, Wong TY (2018) Age-related macular degeneration. 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Dr Sivaprasad has the following disclosures: Consultant (C): AbbVie, Adverum, Alimera Sciences, Amgen Inc., Apellis Pharmaceuticals, Inc., Astellas, Bayer Healthcare Pharmaceuticals, Biogen, Boehringer Ingelheim, Clearside bio, Novartis, EyeBiotech, Eyepoint Pharmaceuticals, Eyexora, 4DMT, Janssen Pharmaceuticals, Kodiak Sciences, Merit, NanOptima, Nova Nordisk, Optos, Ocular Therapeutix, Kriya Therapeutics, OcuTerra, Roche, Sanofi, Stealth Biotherapeutics, Surrozen. Received honoraria\/travel reimbursement from Bayer, Boehringer Ingelheim and Roche. Dr Wong has the following disclosures: Consultant for Abbvie Pte Ltd, Aldropika Therapeutics, Bayer, Boehringer-Ingelheim, Carl Zeiss, Genentech, Iveric Bio, Novartis, Opthea Limited, Plano, Quaerite Biopharm Research Ltd, Roche, Sanofi, Shanghai Henlius. He is an inventor, holds patents and is a co-founder of start-up companies EyRiS and Visre, which have interests in, and develop digital solutions for eye diseases. Dr Lanzetta has the following disclosures: Consultant (C): 4DMT, AbbVie, Adverum, Apellis, Bausch & Lomb, Bayer, Biogen, Boehringer Ingelheim, Celltrion, I-Care, EyePoint, Genentech, MSD, MSD, Novartis, Ocular Therapeutix, Outlook Therapeutics, and Roche. Dr Charles Wykoff has the following disclosures: 4DMT (C, R), AAVantgarde (C), AbbVie (C, R), ADARx (C), Adverum (C, R), Alkeus (C), Altos (C), AMC Sciences (C), Amgen (R), ANI (C, R), Annexon (C, R), Apellis (C, R), Arrowhead (C), Ashvattha (C), Astellas (C, R), Aviceda (C, R), Bayer (C, R), Biocryst (C), Boehringer Ingelheim (C, R), Chengdu Kanghong (C), Eyconis (C), EyeBiotech (C, R), EyePoint (C), Genentech (C, R), Glaukos (C, R), Harrow (C), Ikarovec (C), InGel (C, SO), IONIS (R), Janssen (C, R), Kalaris (R), Kiora (C), Kodiak (C, R), Kyowa Kirin (C, R), LENZ (C), Merck (C), MingSight (C), Nanoscope (C, R), Neurotech (C, R), Novartis (C, R), Oak Bay Bio (C), Ocugen (R), Ocular Therapeutix (R), Ollin (C, R,SO), ONL (SO), Opthea (C, R), Opus (C), Osanni (C, SO), Perceive Bio (C, R), Perfuse (C), Pykus (R), Regenerative Patch (R), Regeneron (C, R), RegenXBio (C, R), RetinAI (C), Roche (C, R), Samsung Bioepis (C), Sanofi (C, R), Santen (C), SciNeuro (R), Skyline (C, R), Stealth (C, R), Surrozen (C), Sylentis (C), THEA (C), Therini (C), Topcon(C), Visgenx (C, SO), Vitranu (SO), Zeiss (C), ZipBio (C).","order":1,"name":"Ethics","label":"Disclosures","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Dr SriniVas Sadda serves on the Editorial Board of Graefes Archive for Clinical and Experimental Ophthalmology, but had no role in this manuscript\u00b4s review.","order":2,"name":"Ethics","label":"COI statement","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"None.","order":3,"name":"Ethics","label":"Prior submission to other journals","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","label":"Competing interests","group":{"name":"EthicsHeading","label":"Declarations"}}]}}