Selective Photothermal Ablation (SPA) of Meibomian Glands Using a High Intensity 1726 nm Laser

Abstract

Purpose : In dermatology, selective photothermolysis using a high intensity 1726 nm laser to preferentially heat lipid and ablate skin sebaceous glands has been developed as a treatment strategy for acne. The objective of this study was to investigate the effect of this laser light on eyelid tissue to selectively remove meibomian glands without damage to surrounding tissues.

Methods : C57Bl/6 mice were sacrificed and the upper eyelids removed and treated using the FDA approved AviClear 1726 nm laser (Cutera Inc., Brisbane, CA) using a 500 μm beam diameter at varying energy levels of 3 to 9W. A 12 cycle periodic train, consisting of 10 ms on and 10 ms off pulses, delivered an effective 120 ms pulse duration. Pulses were delivered through a contact cooling system to prevent hyperthermal tissue damage. Each eyelid received one laser treatment at the center of the eyelid margin overlying the meibomian glands. To document the effects of SPA, eyelid meibography was performed before and after the SPA treatment. Tissues were then fixed in 2% PFA overnight, and processed for paraffin embedding, tissue sectioning, H&E staining, and fluorescent imaging.

Results : The 1726 nm laser, operating at or above 9W, caused damage to the whole tissue. While operating at approximately 5W power however, the laser selectively heated meibum lipid while preserving the integrity of the conjunctiva on ex vivo mouse eyelids. Meibography images taken at this power revealed obliteration of the meibomian glands. H&E imaging and fluorescent imaging further confirmed the destruction of the meibomian gland acinar structures while the conjunctiva exhibited no discernible changes.

Conclusions : This data suggests that SPA treatment of the mouse eyelid can selectively destroy the meibomian gland without damage to surrounding tissue. Further studies are required to determine optimal laser parameters. We propose that this approach may be used for the selective ablation of the meibomian glands to study meibomian gland regeneration and potential renewal.

This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.

 

Before and after meibography images of SPA treatment conducted on an ex vivo mouse eyelid. The meibomian gland was selectively ablated without damaging the surrounding tissue.