ESCRS - PO687 - Laser Scleral Microporation: A Novel Approach For Optimized Ocular Drug Delivery

Laser Scleral Microporation: A Novel Approach For Optimized Ocular Drug Delivery

Published 2025 - 43rd Congress of the ESCRS

Reference: PO687 | Type: Free paper

Authors: Farhad Hafezi* ¹ , Léonard Kollros ¹ , Emilio Torres-Netto ¹ , Shady Awwad ² , M. Enes Aydemir ¹ , Mark Hillen ¹ , Nikki Hafezi ¹ , Francesco Versaci ³

¹ELZA Institute,Zurich,Switzerland, ²Ophthalmology,American University of Beiruit,Beiruit,Lebanon, ³CSO Italia,Scandicci,Italy

Purpose

Non-invasive laser scleral microporation (LSM) has emerged as an innovative approach to enhance drug permeation across the sclera by creating controlled micropores while minimising collateral damage. This study aimed to characterise LSM micropores created usinga proprietary 2.94um Er:yag diode pumped solid state (DPSS) laser system (Ace Vision , Boston , USA)laser devic in ex vivo porcine sclera studies through advance imaging techniques. A comprehensive evaluation of micropore morphology, collagen architecture, and its impact on drug permeation was conducted to assess the feasibility of LSM in enhancing ocular drug delivery for anterior and/or posterior segment diseases.

Setting

The study was conducted at the School of Pharmacy, Queen’s University Belfast, UK, in collaboration with Ace Vision Group, Boston, MA, USA. Ex vivo porcine sclera was used under controlled conditions to evaluate micropore characteristics, structural integrity, and drug permeation kinetics. LSM was performed at target depths of 50% and 85%, with a power setting of 0.9W, a pore density of 10%, and an array size of 5 mm, creating 49 pores in a diamond matrix in the four oblique quadrants of the eye

Methods

Porcine sclera was microporated using a 2.94um Er:Yag laser device at 50% and 85% depths in 5 critical anatomical and physiological zones. Micropore morphology was analysed using: Multiphoton microscopy (MP-SHG) to visualise the collagen architect at different depths (200-1000 µm), Haematoxylin and Eosin (H&E) staining for pore structure and collateral damage assessment, Scanning Electron Microscopy (SEM) for surface micropore analysis, and Transmission Electron Microscopy (TEM) to compare collagen integrity in treated vs. untreated sclera. Drug permeation was evaluated using Franz-diffusion Cells (FDCs) with prednisolone acetate (PA), comparing untreated and laser microporated sclera.

Results

Imaging confirmed well-defined micropores (Zones 0–4) with minimal collateral damage. Pore depths in LSM treated sclera ranged from 250–750 µm where the average thickness of sclera was 1000 µm. MP-SHG, SEM, and TEM revealed distinct pore morphology and intact collagen on the walls of LSM micropores following LSM treatment. FDC studies demonstrated significantly enhanced PA permeation in 85% LSM-treated sclera vs. 50% and untreated controls (n=3). PA delivery increased from 4.4 µg (untreated sclera) to 76.4 µg (85% LSM depth) over 24 hours, confirming improved drug permeation through the scleral tissue.

Conclusions

LSM enhances scleral drug permeation by creating controlled micropores with minimal disruption. This study fully characterizes LSM micropores using advanced imaging tools, providing significant insights into pore morphology and collagen biomechanics. FDC results confirm significantly higher drug permeation in microporated sclera, supporting LSM for ocular drug delivery in both anterior and posterior segment diseases. Integrating nanotechnology-based drug delivery with LSM could further enhance localized, sustained ocular drug delivery. A dual-therapy approach combining LSM with an ocular drug delivery system holds promise as a pioneering strategy for precise,sustained treatment of posterior ocular diseases, enhancing permeation and efficacy