Managing Complications Associated With the Port Delivery System
By Jean Shaw
Selected by Andrew P. Schachat, MD
Journal Highlights
Ophthalmology Retina, November 2022
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The Port Delivery System (PDS) includes a permanent, indwelling, and refillable ocular implant that provides continuous release of a customized formulation of ranibizumab. It is approved for the treatment of neovascular age-related macular degeneration (AMD). Awh et al. set out to provide strategies for the management of key ocular adverse events that may be encountered with the PDS in everyday clinical practice.
This safety evaluation was based on two key studies of the PDS, the phase 2 Ladder and phase 3 Archway trials. Procedural videos and eye or implant images collected during the trials were systematically reviewed.
The researchers identified and described the following key adverse events that may arise after insertion of the PDS or the refill-exchange procedures: conjunctival retraction and conjunctival erosion; endophthalmitis; implant dislocation; conjunctival bleb and conjunctival filtering bleb leak; wound leak, hypotony, or choroidal detachment; vitreous hemorrhage; retinal detachment; cataracts; and septum dislodgment. For each category, they provided recommendations for patient examination and management.
Surgeons should be aware of these potential complications and take steps to identify them early in order to achieve optimal outcomes, the researchers said. They noted that patient selection is key—for instance, patients with thin or scarred conjunctiva are not ideal candidates for the PDS—and recommended careful assessment of the ocular surface before any planned PDS procedure.
The original article can be found here.