Retina World Congress 2026: Port Delivery System shows durable outcomes at 7 years in neovascular AMD

Seven years of follow-up data from the Port Delivery System (PDS) clinical trial program represent the longest data set from any wet age-related macular degeneration (AMD) clinical trial program to date. That was the central message from Carl D. Regillo, MD, FACS, director of the Retina Service at Wills Eye Hospital in Philadelphia, professor of ophthalmology at Thomas Jefferson University, and partner at Mid-Atlantic Retina, who presented the findings at Retina World Congress 2026, May 14 to 17, in Fort Lauderdale, Florida.

Regillo described the Port Delivery System as a sustained release reservoir device that administers ranibizumab in zero-order-like kinetics over long periods of time, at least 6 months. The 7-year data set draws from the original phase 2 LADDER trial (NCT02510794), in which patients were implanted with PDS, as well as the control arm from that study, which subsequently rolled over to receive PDS as part of the PORTAL extension program (NCT03683251).

Long-term efficacy and safety

Regillo highlighted 2 key findings from the long-term data. On efficacy, he noted that when comparing PDS with real-world anti-VEGF biologic injections over an extended timeframe, PDS "clearly outperforms," with patients maintaining vision gains through the maintenance phase with very little decline in best-corrected visual acuity over the course of 7 years. On safety, he noted that most adverse events occur around the time of surgery or shortly thereafter, and that over time these become less frequent. "It's comforting to know that we have seven years of follow-up that we can tell patients what to expect having this device," he said.

Regarding patient selection, Regillo identified the strongest candidates as those requiring frequent treatment to adequately control their wet AMD, as well as patients who have difficulty getting to the office for timely injections or experience significant anxiety or discomfort associated with injections. He described patients receiving injections every 4, 6, or 8 weeks as "clearly the sweet spot" for PDS candidacy, while noting that patients well controlled on injections every 3 to 4 months may be less inclined to pursue the device.

Regillo also addressed the broader implications of the PDS data for the sustained delivery landscape, noting that the program demonstrates that continuous zero-order delivery is "really the best way to control wet AMD and frankly probably most of our common retinal diseases" managed with anti-VEGF therapy. He noted that PDS is now FDA approved for wet AMD, diabetic retinopathy, and diabetic macular edema, and that the long-term safety data from the PORTAL program provides a model for evaluating other sustained delivery approaches including bioerodible inserts with tyrosine kinase inhibitors and gene therapy.

"We're clearly going in the direction of sustained delivery in general to manage wet AMD in the maintenance phase," he concluded.