Successful Cataract Surgery in a Patient with a Port Delivery System Implant for Diabetic Macular Edema - Case Report

Sep 30, 2026

Introduction: The Port Delivery Platform (PDS) with ranibizumab is a surgically implanted, refillable device intended for continuous intraocular anti-VEGF release, approved for neovascular age-related macular degeneration and also for diabetic macular edema (DME) and diabetic retinopathy. Case Presentation: A 72-year-old woman with DME received a PDS implant through the Pagoda trial and underwent uncomplicated cataract extraction with intraocular lens implantation using clear corneal incisions while avoiding conjunctival or implant manipulation. Conclusion: The implant remained stable intraoperatively and postoperatively, vision improved, and refill was completed without complications, underscoring key surgical precautions to preserve implant integrity and conjunctival health.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages6

Reading Time15 min

AccessFree to download

Introduction

Case Presentation

Patient history and enrollment

Surgical procedure and perioperative course

Conclusion

Case Reports in Ophthalmology | Case Rep Ophthalmol 2026;17:26–31 | | | --- | --- | | DOI: 10. 1159/000548644
Received: June 28, 2025
Accepted: September 14, 2025
Published online: December 12, 2025 | © 2025 The Author(s) .
Published by S. Karger AG, Basel [www.karger.com/cop](www.karger.com/cop) | This article is licensed under the Creative Commons Attribution-NonCommercial 4.0 International License (CC BY-NC) ([https://karger.com/Services/OpenAccessLicense](https://karger.com/Services/OpenAccessLicense)). Usage and distribution for commercial purposes requires written permission. Case Report Successful Cataract Surgery in a Patient with a Port Delivery System Implant for Diabetic Macular Edema Jeffrey Chu a Ramez I. Haddadin b Manjot Gill b a Department of Ophthalmology and Visual Sciences, Case Western Reserve University School of Medicine, University Hospitals Cleveland Medical Center, Cleveland, OH, USA; b Department of Ophthalmology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA Keywords Port Delivery Platform with ranibizumab · Cataract surgery · Diabetic macular edema Abstract Introduction: The Port Delivery Platform (PDS) with ranibizumab is a novel, surgically implanted device designed for continuous intraocular anti-VEGF delivery, approved for neovascular age-related macular degeneration and other retinal vascular diseases, including diabetic macular edema (DME) and diabetic retinopathy. While it can reduce treatment burden, the PDS implant introduces unique surgical considerations, particularly during subsequent ocular procedures. Case Presentation: We report a case of successful cataract extraction and intraocular lens implantation in a 72-year-old female with a PDS implant for DME, enrolled in the Pagoda trial. Cataract surgery was performed via clear corneal incisions while carefully avoiding manipulation of the conjunctiva or implant. The procedure was uneventful, and the implant remained stable intraoperatively and postoperatively. The patient experienced improved visual acuity and underwent an uncomplicated implant refill after 15 days with confirmation of adequate implant coverage at the 6-month follow-up. Conclusion: This case highlights key surgical considerations to preserve implant integrity and conjunctival health during cataract surgery in eyes with PDS implants. To our knowledge, this is the first report of cataract surgery in a PDS-implanted eye outside a clinical trial, emphasizing that standard phacoemulsification techniques can be safely adapted with proper precautions in this context. © 2025 The Author(s) . Published by S. KargerAG, Basel Correspondence to: Jeffrey Chu, jeffrey.chu2 [uhhospitals.org](uhhospitals.org) Case Reports in Ophthalmology Case Rep Ophthalmol 2026;17:26–31 27 | DOI: 10. 1159/000548644 | © 2025 The Author(s) . Published by S. Karger AG, Basel [www.karger.com/cop](www.karger.com/cop) | | --- | --- | Chu et al.: PDS Implant for Diabetic Macular Edema Introduction The Port Delivery Platform (PDS) with ranibizumab is a surgically implanted, refillable drug delivery system within the sclera that is designed for continuous passive release of anti-VEGF therapy into the vitreous cavity. This treatment modality has been FDA-approved for the management of neovascular age-related macular degeneration, diabetic macular edema (DME), and diabetic retinopathy [1–4] . While the PDS implant has the potential to reduce treatment burden while also maintaining therapeutic outcomes [1–3], complications such as conjunctival retraction and erosion, endophthalmitis, implant dislocation, choroidal and retinal detachment, and vitreous hemorrhage have been noted in the literature [4] . In addition, cataract formation and progression of preexisting cataracts were observed in the phase 2 Ladder and phase 3 Archway PDS trials. Cataract surgery was successfully performed in all 8 patients without deviation from standard surgi

FAQs

What is the Port Delivery Platform (PDS) with ranibizumab designed to do?

It is a refillable, surgically implanted device intended for continuous intraocular release of anti-VEGF therapy into the vitreous cavity.

How was cataract surgery performed in the reported patient?

Cataract extraction with intraocular lens implantation was performed via clear corneal incisions, carefully avoiding manipulation of the conjunctiva or the PDS implant.

What outcomes were reported after cataract surgery and subsequent implant refill?

The procedure was uneventful, the implant remained stable intraoperatively and postoperatively, visual acuity improved, and an uncomplicated implant refill was performed with confirmation of adequate coverage at 6 months.

Sep 30, 2026

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