Lacrimal Gland PRP injection & PRP drops - Prof. Alio, Vissum, Alicante

[Alix]

*If* hot compresses help you, then it's effective and convenient.

Worth trying other methods of heat first to confirm that it is a good thing for you, I think.

Thank you. The hot compresses do not help, they make my eyes bloodshot, and my eyes still feel dry afterwards.
However humidity seems to help because after a shower my eyes feel normal albeit not for very long. I will try doing hot compresses again but at a lower temperature.

[Guest]

Thank you. The hot compresses do not help, they make my eyes bloodshot, and my eyes still feel dry afterwards.
However humidity seems to help because after a shower my eyes feel normal albeit not for very long. I will try doing hot compresses again but at a lower temperature.

Try doing it so low you barely feel the heat and do that for a long time. I’ve found that the compress has to cool completely on my eyes. If I take it off too soon, my warm eyes meet with the cold air and tears will evaporate much faster. If I let the compress cool completely on my face, my eyes are nearly room temperature so they adjust better.

If your eyes are red and bloodshot and more dry after compress, it was probably too hot. If I could go back, the one ting I would do different is a warm compress, not hot...and for much longer. I used to get it real hot and after 5 mins, I would get up and reheat it. At the time, I may have actually needed that. But as I got in better medications I was able to pull back on the heat. Specifically I went from 45C then to 40C now. I use a laser thermometer, but most people won’t do that. Just make sure you barely feel the warmth, of it feels hot at all and not warm and comforting, pull it off and let it cool.

ive never used blephastean so I would only be speculating.

[farmgirl]

It would make sense to do. However, my dry eye problems begin soon after an IPL facial treatment (and became worse with a subsequent one). No way of knowing if that caused it, but it makes me too nervous to do again.

I think it is important to understand that IPL for facial treatment and dry eye treatment are two very different things. The machine for dry eye is calibrated differently and the eye is protected. The important thing is the expression afterwards of the old thickened up oils so that the new oils can start flowing freely. If you feel that your problem is in part related to blocked glands, although I understand why you might have some reservations about IPL I think it would be a mistake to pass on a treatment that has helped many others. Traditionally IPL for a facial treatment is not credited with helping dry eye, they are two very different things.

[Meibum Ian]

I think it is important to understand that IPL for facial treatment and dry eye treatment are two very different things. The machine for dry eye is calibrated differently and the eye is protected. The important thing is the expression afterwards of the old thickened up oils so that the new oils can start flowing freely. If you feel that your problem is in part related to blocked glands, although I understand why you might have some reservations about IPL I think it would be a mistake to pass on a treatment that has helped many others. Traditionally IPL for a facial treatment is not credited with helping dry eye, they are two very different things.

I have to disagree somewhat..

The practioners who use IPL for dry eye here use a Lumenis M22 with 590nm wavelength filter and ~14kj power. This is pretty much the same as I had done (and in same areas of face). I did have eye protection but as you say, no MG expression afterwards.

Also, I understand that IPL started to to be used as a treatment for MGD when patients having facial treatments found their eye conditions improved.

My thoughts are actually that IPL would be more likely to help than harm me, but that if I did it and it made things worse than they are now I couldn't forgive myself.

I do not want to deter others from having the treatment as it generally does seem effective.

[farmgirl]

If I am not mistaken, and I could be, the wavelength for the eye is gentler than what you would use on the face, that is you can't safely take a machine calibrated for the face and use it on the eye. The expression is the key part to the success of the treatment you need to express those old oils.

I found 2 case studies of instances where facial IPL actually damaged the eye and in both cases the protective eye shield was removed to reach a freckle near the eye. It seems that whoever was doing your treatment was lax with your eye protection or the goggles they were using were not sufficient for proper protection...shame, I hope for your sake they didn't do permanent damage.

[Meibum Ian]

If I am not mistaken, and I could be, the wavelength for the eye is gentler than what you would use on the face, that is you can't safely take a machine calibrated for the face and use it on the eye. The expression is the key part to the success of the treatment you need to express those old oils.

I found 2 case studies of instances where facial IPL actually damaged the eye and in both cases the protective eye shield was removed to reach a freckle near the eye. It seems that whoever was doing your treatment was lax with your eye protection or the goggles they were using were not sufficient for proper protection...shame, I hope for your sake they didn't do permanent damage.

The wavelength is the same (590nm). the power (measured in kilojoules) would be about the same. The other variable is pulse count / duration. The areas treated would be the same (not directly on eyelids but around them).

I do not believe I have any eye damage from the IPL. However, IPL is known to be able to trigger inflammatory responses and neovascularization / angiogenesis. I don't think these possible side effects should be ignored although they generally do seem to be (probably out of ignorance).

[farmgirl]

I am happy that your damage was not permanent and I agree it is easy to say that there are no side effects only to have some who (like in the cases of lasik induced dry eye) are saying they felt they had suffered adverse side effects only to be blown off.

I thought that IPL was supposed to help get rid of neovascularizaton which is why it is commonly used for rosacia so I don't quite understand why a treatment that could induce it would be used to treat it.

[Alix]

Try doing it so low you barely feel the heat and do that for a long time. I’ve found that the compress has to cool completely on my eyes. If I take it off too soon, my warm eyes meet with the cold air and tears will evaporate much faster. If I let the compress cool completely on my face, my eyes are nearly room temperature so they adjust better.

If your eyes are red and bloodshot and more dry after compress, it was probably too hot. If I could go back, the one ting I would do different is a warm compress, not hot...and for much longer. I used to get it real hot and after 5 mins, I would get up and reheat it. At the time, I may have actually needed that. But as I got in better medications I was able to pull back on the heat. Specifically I went from 45C then to 40C now. I use a laser thermometer, but most people won’t do that. Just make sure you barely feel the warmth, of it feels hot at all and not warm and comforting, pull it off and let it cool.

ive never used blephastean so I would only be speculating.

Thank you, I will try this and report back.

[Meibum Ian]

Day 58 update:

Just had my followup with prof. Alio..

He's happy with the improvement.

• Meibomian glands mostly producing normal oil
• schirmer i (with anaesthetic) 5mm (0mm pre treatment)
• right eye no staining, left eye slight staining (grade 1 / 2 pre treatment)
• Tear meniscus forming quickly after tears wiped away.
• no inflammation seen, as detected by slit lamp and (I think) keratography
• conjunctivita looking more hydrated / better homeostasis

Overall he said that I've gone from 3/10 to 8/10. I'm happy that symptoms generally seem to match signs with me.

Will continue with PRP for 2 months, then another followup. We're hoping to see further improvement in tear production / schirmer result by then.

[hopeful_hiker]

Congratulations on your progress! PRP sounds really promising for restoring lacrimal glands.

[hopeful_hiker]

Congratulations on your progress! PRP sounds really promising for restoring lacrimal glands.

[farmgirl]

Some day we will have this treatment here in Canada, I will be waiting. I am happy to hear that you have had very positive results.

[Meibum Ian]

Some day we will have this treatment here in Canada, I will be waiting. I am happy to hear that you have had very positive results.

Thank you. I believe Dr Cremers does it in the US, if that's any help.

[farmgirl]

Thanks Ian I was aware of her but haven't heard any reports of people who have been helped by what she is doing only Pythonidler who said it made him worse so I wasn't inspired to try it. How are you feeling day to day relative to before I am assuming from a 3 to an 8 if your symptoms match your signs.

[Meibum Ian]

Thanks Ian I was aware of her but haven't heard any reports of people who have been helped by what she is doing only Pythonidler who said it made him worse so I wasn't inspired to try it. How are you feeling day to day relative to before I am assuming from a 3 to an 8 if your symptoms match your signs.

Yes I also saw pythonidler's posts, before I had the procedure done. Without denying the possibility, I didn't feel that worsening of the condition was a likely outcome, for me at least.

I am definitely feeling better than before the procedure. Maybe from 3 to 6 though? A few days ago I had about 60 seconds, sat in a cafe, where I realised I couldn't feel my eyes. Probably the first time in a year that's happened. Still struggle with wind.

My problem is still a couple of nearly-always-blocked glands in each upper lid, making my blink painful and giving foreign body sensation. When these occasionally open up I really do feel good.