LipiFlow device - what the????

[pythonidler]

Hi Joe,

Lipiflow, IPL, and probing are probably the most talked about procedures on this forum. I'm aware of a couple other options as well:

• MiBo Thermoflo, by MiBo Medical Group - a heated massage of the outside of the eyelids. My intuition tells me this procedure is not likely to more effective than a heat mask you can put into the microwave, since it heats the glands from the outside.
• Heated manual expression - like probing, but using heated probes instead of cold ones. As far as I'm aware, only Dr. Korb out of Boston has offered this procedure. But since Dr. Korb is affiliated with TearScience, the maker of Lipiflow, I'm not sure he offers heated manual expression anymore.

My doctor did probing on me, and told me it is meant to be a one-time procedure to clear out scar tissue. All the other procedures (Lipiflow, IPL, etc) are maintenance treatments to be done every few months, to keep the oils flowing. When asked him to rank the effectiveness of these maintenance treatments he said it was, in order from most effective to least effective:

1. Heated manual expression
2. IPL
3. Lipiflow

Personally, I've had both IPL and Lipiflow done. Neither worked for me before I had probing done, probably because the scar tissue was blocking my glands. After I had my probing a few months ago, I had three more IPL treatments and am due for my 4th next week. I noticed an improvement after my second IPL. I'm lucky in that I've found a doctor who can do this procedure for a relatively cheap price. Additionally, my insurance has accepted my claims on IPL, and once I meet my deductible (which I probably already have), they will only cost me $35 per session.

In conclusion, for me IPL is probably the best "bang for the buck." Lipiflow may be less effective, and is an order of magnitude more expensive than IPL.

[regularjoe]

I am new to the forum, and trying to wrap my head around the all of this stuff, specifically with regard to Meibomian Gland Dysfunction (MGD) which I suffer from.

From my readings here and elsewhere, it seems there are 3 Heavy Hitter procedures you can have done for MGD:

1. Lipiflow
2. IPL
3. Probing

Am I missing a big procedure, or is that the Big 3? And, though I am sure it is a can of worms even asking, what is considered to be the most effective option of the 3? The least expensive? The least dangerous? The best bang for the buck?

My cursory reading gives me the impression Probing offers the best results, but is the most expensive and dangerous; requires the most surgical skill. IPL is the least invasive, and least expensive, and I haven't read any injuries from it, and I feel like it is considered more effective than Lipiflow. Lipiflow seems like it is the most common treatement, best marketed, middle-of-the-road in expense, but usually only mildly effective?

May be I have this all wrong? Maybe I am missing an effective surgical intervention? Please let me know! I am new, but have done a ton of reading here.. I may be confused.

FWIW, I live in Toronto, and only Lipiflow is offered here. There are some doctors offering IPL in my province, but (surprisingly) they are a few hours away. No one offers Probing, but if this was the Holy Grail I would do what I needed to, travel-wise, and expense-wise. But so far I am not sold on it.

Thanks so much! *smiley icon*

Regular Joe

[LindaDawn]

Hi Kane, Sorry to hear to hear about your eyes. How did you get on with Lipiflow?

[Waesk]

Hi Guys,

I have been lurking on this forum everyday for the past 4 months.

I have MGD and evaporative dry eye.

I have tried warm compress, Pred forte, Optimel Manuka honey and many different tears.

My condition has been getting worse over time. Eyes are burning and are bloodshot with a lot of veins.

I am scheduled in for my first lipiflow session today.

I will keep you updated on how I get on.

Cheers,

Kane

[Dryeyekami]

Hi hoku

That's what I think too. Allergy and dry eye mimic symptoms so all very confusing especially when I'm now being told my glands are fine and working compared to a couple of weeks ago when I was told I had mgd....

So I'm assuming allergy can cause your eyes to feel dry and irritated too.

[Hokucat]

There are many posts in this forum about allergies and dry eyes...try doing a search on that. Happened to see this article someone shared that seems to confirm that relationship:

http://www.ophthalmologymanagement.c...sting-pays-off

Perhaps the papillae on your eyelids is compromising the ability of your lids to close properly and sweep the oils from your glands over the eyes, like they normally would. Either way, seems you might want to address the allergies theory first.

[Dryeyekami]

The question then is ....What do I have? Can dry eyes be a symptom of an eye allergy?

[MGD1701]

you need to identify root causes - different causes need different drops/solutions etc. If you dont have MGD, no need to do warm compress, I guess.

[Dryeyekami]

Unfortunately the NHS do not usually allergy test. I've narrowed it down to two things.... Hay fever or a face wash I started to use. Doc said my tears are fine so lipiflow would not help. Said the glands look fine and open too. So I may just be having a very very long allergic reaction.

So the question is ... Do I have mgd. He thinks not but my eyes are still sore!

[MGD1701]

Hi Dryeyekami
thanks for the update/sharing. Indeed you are lucky to find an honest dr. who told you NO point in doing LipiFlow.

With respect to drop - my doctor says we should apply drop BEFORE eyes feel dry otherwise it will damage conera. More (forceful) blinking exercise helps.

Allergies - maybe it is good to do a test in order to identify the source??

[Dryeyekami]

An update on my lipiflow...I saw my opthalmologist recently.... First one of the three I've seen to actually spend time with me ( probably as I payed for the service this time as opposed to the NHS). He's telling me I have allergies and my tear film is ok.... I have papillae and droopy eyelids symptomatic of allergies.... I'm now veeeery confused! He told me there's no point in me doing lipiflow!

[Dryeyekami]

I too am trying to avoid artificial tears as much as possible....

[MGD1701]

Retain MGD - Any idea if there are similiar alternatives in Europe? I have heard many good things about this, many doctors highly recommend it. Seems it is better than Systance Balance as it has no preservative??

My new approach (based on my research):
try to reduce drops as they are not so helpful and wash away our precious tears.
I warm eyes with hot towl/water then massage a bit (tota1-2 min.) which really helps.

MGD suffers need oil-based drop to increase lipi layer thickness (& protect cornea too??).

[PhoenixEyes]

I dont know Hylo forte but if you have MGD, you need oil-based drops.

Systane Balance has mineral oil in it and is available both on NHS prescription or over the counter.

Just wish you could get it preservative free, from what I've read on the forum though the preservative in it (POLYQUAD polyquaternium-1) is meant to be much better than the typical BAK (benzalkonium chloride) that bothers a lot of people. I sadly didn't get along well with it but ophthalmologists highly recommend it and others on the forum here have found it helpful, so I'd still say it's a good idea to give it a go.

I've also heard of Retaine MGD which has mineral oil in it and I think has a preservative free option but I've a feeling it might not be available in the UK yet over-the-counter or on NHS. Hopefully someone can prove me wrong though. It can be ordered online from US though I think.

Hyloforte is a Sodium Hyaluronate drop. You can also get a slightly thicker version called Clinitas Multi. Both available over the counter or on NHS prescription. I do find them to be helpful and thankfully they're available preservative free.

[MGD1701]

Great Dryeyekami, if all are in the right track. I dont know Hylo forte but if you have MGD, you need oil-based drops.

Ointment: I dont use it anymore as it only creates more problems, especially in the morning. I used it for a few years as instructed by doctors.

Omeg 3, 6: My blood tests show my levels are almost double than normal. My dr said it is ok. I eat lots of nuts daily.