LipiFlow device - what the????

[Hokucat]

BTW, Lipiflow did not work for me at all, likely because my meibomian glands had gotten so blocked and caked over time with thick meibum/oil. However, the expressing and probing procedures were able to remove some of the blockage temporarily. Maybe Lipiflow will work even better for you if you express and/or probe first.

[Hokucat]

HI. Have you ever looked into PROSE scleral lenses? It's a nickel size dome-shaped contact that keep a layer of saline over your eye. These are being used more and more for dry eye sufferers with great success. I wear mines 12 hours a day, they work well for me.

Like you, I also had issues with the oil from my meibomian glands...it was confirmed mines was very thick. Its much better now because for whatever reason, adding fresh squeezed lemon to my daily green tea significantly reduced my dry eyes by making my oil less viscous - I posted a few days ago under Dry Eye Triumphs forum. If there is very little oil coming out of your glands because it is thick and clogging up your glands (versus your glands not generating much oil), perhaps this will work for you too. If you have a doctor express and/or probe your meibomian glands, he/she should be able to tell you the consistency and clear out any blockage there is, so that any subsequent diet changes or treatment related to your glands have the best chance to work.

[Bibliogirl]

Mooner, so sorry for the delayed response. I often browse the posts without logging in, so did not see your post right away.

Well, as my luck would have it, not long after my post (about a month actually) my eye woes really flared up again. Fall seems to be problematic for me.

Long story short, I tried IPL sessions - not much help-- then had Lipiflow again in November. Once again, I could feel a really dramatic difference. The persistent blepharitis I was dealing with in my left eye cleared up, I have less burning etc.

I've stopped the spironolactone drops for now. I really took a shotgun approach to treatment and was trying so many things that I wasn't sure what was helping.

At this point, I know the following have definitely helped (in no particular order):

1) Lipiflow
2) Daily heat masks and massage
3)Daily blinking exercises
4) Quadra plugs (recently lost an upper plug and could tell a big difference)

I just got a prescription for Xiidra and will try it after the holidays. I'm also looking into Regenereyes.

Overall, I'm definitely better than I was when this began in June 2015, but still searching for greater relief.

[DocwithDryEye]

In my experience, I have found that sometimes (not always), I can still express some meibum immediately after the procedure. In my opinion, everyone has different eye anatomy, and every eye doesn't grip the activator in the same way. Those eyes that do grip well rarely have anything else come out after the procedure. Many eyes, however, do. I feel that the activator is FANTASTIC at melting meibum to correct temps to express, and that by manually expressing every patient that has the procedure, we will get the best outcome. Blink exercises, fish oil, warm compress, lid hygiene, water consumption, lid taping if have nocturanal lagophthalmous all vital afterward.

[MGD30]

Lipiflow is a very effective expression when the meibomian oil is heated so there would be no reason to do a another expression right after. Im fairly certain Dr. Korb doesnt do them after a treatment. You can do them yourself after warm compresses by pinching your eye lids, after the Lipiflow treatment to keep the glands from clogging up again. Hard blinking exercises also help.

[JJdryeye]

I'm hoping either a doctor here or a patient who's had Lipiflow can help me out here. From what I understand, some doctors, including Dr. Korb, are performing manual gland expression immediately following Lipiflow. I'm wondering how important this is, and for those doctors who do it, is it something you do for every Lipiflow patient, or case by case?

[dryeyeblues]

Hi checking in Day 7 post Lipiflow. It has helped a lot (still have to use drops), but less. I've created a couple new blogs on using Systane, various other drops, and serum drops here: http://www.lasikdryeyeblues.com/dry-eye-blog

[Angela810]

Very happy to hear you had a good outcome - gives me hope. Sounds like you are making a good recovery from your surgery. Well done

[JJdryeye]

Hi JJ

I would put lid margin debridement at 'moderately helpful' pre Lipiflow but it really depends on the state of your lids and how long your meibomian glands have been blocked for. If you have a significant build up of dead skin cells or hardened meibum covering the meibomian gland orifices (tiny holes where the oil comes out on the lid margin) then debridement with a gold club spud can help clear this part of the blockage to make it easier for Lipiflow to heat and squeeze out blockages deeper in the glands, increasing the chance that Lipiflow will be able to express more of your glands as there is less resistance to do so.

The main benefit of debridement is in addressing lid wiper epitheliopathy which does not actually directly improve the results from Lipiflow, other than the fact that it improves the lid wiper reducing the mechanical trauma from LWE & the inflammation situation overall. This can help given how things are linked. I debride my own lids about once a fortnight before manual expression using a gold club spud and a 20x mirror and it does help significantly, in both smoothing the lid wiper and releasing a small number of glands that actually have liquid oil in them but are just capped at the orifice. However unfortunately most of my glands are blocked deeper down.

I think that you can get a lot of the benefit that a in office debridement procedure provides by gently scrubbing the lid margin yourself with warm saline on a q-tip. Ensure that the water is not too hot - for example by wetting a q-tip and touching it on your skin first before dipping another one to use on the lid. If you do this 3 or 4 times before the Lipiflow it should give you most of benefit that in office (most likely with golf club spud) would provide.. The in office debridement with a golf club spud is actually quite a gentle process - the edge of the instrument should glide along the lid margin and at no point draw blood.

Hope it goes well for you

Spoon,

Thanks for your reply. I'm curious, you seem to be fairly well versed in this subject, where did you obtain this information on the q-tip method? Dr. Latkany uses this as part of his Home eye spa treatment, but as a way of cleansing the eyelid after heat and massage. Did a doctor say this was a good replacement? Not doubting you or anything, I just always like to know my source when I try something new.

After contacting about 20 offices that perform Lipiflow, I'm finding that at least half (probably more like 60-70%) are including lid margin debridement in the Lipiflow procedure/price. And some are using Blephex to exfoliate the lid margin instead of the spud instrument. Blephex appears to be more aggressive than the spud, so I'd be curious to know if anyone here as an opinion on that. I'm guessing many doctors are following Dr. Korb's lead on the debridement, but I suspect they are getting better results for so many doctors to be including it.

I would also add that I was pleasantly suprrised to find that the cost of Lipiflow is coming down signicantly, you just have to do some leg work and call around.

[Spoon]

Hi JJ

I would put lid margin debridement at 'moderately helpful' pre Lipiflow but it really depends on the state of your lids and how long your meibomian glands have been blocked for. If you have a significant build up of dead skin cells or hardened meibum covering the meibomian gland orifices (tiny holes where the oil comes out on the lid margin) then debridement with a gold club spud can help clear this part of the blockage to make it easier for Lipiflow to heat and squeeze out blockages deeper in the glands, increasing the chance that Lipiflow will be able to express more of your glands as there is less resistance to do so.

The main benefit of debridement is in addressing lid wiper epitheliopathy which does not actually directly improve the results from Lipiflow, other than the fact that it improves the lid wiper reducing the mechanical trauma from LWE & the inflammation situation overall. This can help given how things are linked. I debride my own lids about once a fortnight before manual expression using a gold club spud and a 20x mirror and it does help significantly, in both smoothing the lid wiper and releasing a small number of glands that actually have liquid oil in them but are just capped at the orifice. However unfortunately most of my glands are blocked deeper down.

I think that you can get a lot of the benefit that a in office debridement procedure provides by gently scrubbing the lid margin yourself with warm saline on a q-tip. Ensure that the water is not too hot - for example by wetting a q-tip and touching it on your skin first before dipping another one to use on the lid. If you do this 3 or 4 times before the Lipiflow it should give you most of benefit that in office (most likely with golf club spud) would provide.. The in office debridement with a golf club spud is actually quite a gentle process - the edge of the instrument should glide along the lid margin and at no point draw blood.

Hope it goes well for you

[dryeyeblues]

Or here http://www.lasikdryeyeblues.com/dry-...some-harmonica

[dryeyeblues]

Hey Y'all. I had my first Lipiflow a few hours ago. I don't feel relief (yet), but I'm hopeful it will help. I captured my experience with video, pictures in the office and a blog.

http://www.lasikdryeyeblues.com/dry-eye-blog

Thanks
Matthew

[dryeyeblues]

Thanks for sharing. I have MGD and my first Lipiflow scheduled this Tuesday.
Matthew
www.lasikdryeyeblues.com