My experience with IPL with Dr. Sanjay Kamat

[NeedMyEyes]

Okay, so I finally decided, after 9 months of horrible Meibomian Gland Dysfuntion, to get IPL. I've been on all the meds and done all the warm compresses and of course, no improvement whatsoever.

So, I called Dr. Toyos' office and his assistant gave me the names of all the eye doctors that follow his protocol. The closest to me is:

Dr. Sanjay D. Kamat in Yardley, PA. www.buckseyespecialists.com

I called Dr. Kamat's office and asked about the IPL. He talked to me for a total of 30 minutes on the phone. I asked him to make an appointment ASAP and he agreed to see me that Saturday even though he isn't normally open on Saturdays. Not only that, but the Saturday was his wife's birthday and he still agreed to see me... i was relieved because I really wanted to get started on my treatments.

By the way, he uses the same laser Dr. Toyos uses, charges exactly the same as Dr Toyos - $200 for the intitial and $375 for every treatment after that, does 2 passes on your face and eyelids and even does the expression afterwards. All exactly like Dr. Toyos would do it.

So I arrived on Saturday morning at his office - it is a small office in an office complex in Yardley (about 30 miles north of downtown Philly)

He spent a little over an hour with me during the appointment telling me about the procedure and the results I could expect, etc.

The procedure itself actually didn't hurt at all. I thought it was supposed to burn or feel like a rubberband popping on my skin, but I didn't feel anything. I also thought it would be hot - but it wasn't at all. So I really am not sure anything happened during the procedure.

I was a little worried about the safety of the procedure (because the eye protection you get is these little stick on bandages). He said next time he will put a special protective contact lens in each eye for more protection from the laser.

After he did an expression - and he said that the secretions were looking better than when we started. I don't see how though because I didn't feel a thing - no heat no stinging, nothing. By the way, it was a very thorough expression. He used Qtips on me, but he has had other patients ask for tweezers and paddles for a better expression. The Toyos protocol is just Qtips, so I was okay with that.

My eyes don't feel any different today than they did yesterday (a little wose with the steroid drops actually). So I can't report any immediate improvements.

As far as side effects after the procedure - I don't have anything. I don't see anything on my skin and I don't feel anything in my eyelids or in my eyes. I am taking the Lotemax / Azasite, etc. that he prescribed and that stuff stings my eyes a bit - but that's all.

Anyway, unless something bad happens (I don't THINK it will....), I am sure I will go back to Dr. Kamat for several more treatments. It is a pretty simple procedure and I don't see why you would have to go to Memphis to see Dr. Toyos. Especially since Dr. Kamat does it exactly like Dr. Toyos. Also, he was really nice and was willing to change a few things if I wanted him to.

NME

PS - I'll try to post my future expreiences in this thread and any improvements ...

[NeedMyEyes]

5 days after first IPL treatment...

Okay, so a lot has happened with my eyes since the first treatment, so I thought it was time to post an update:

The first few days after the procedure, I noticed the meibomian glands were VERY prominent - they were sticking out at me in the mirror. So I can tell they were stimulated.

Also, my swollen lower eyelids are gone - further I can see a holllow in my cheeks (like I suddenly got really skinny) that I haven't seen in months (since before I got MGD 9 months ago).

Additionally, the skin where Dr. Kamat treated is really firm and smoot. All of the blackheads I had there are completely gone.

Finally, when I wake up in the morning - there is TONS of oil on my face where Dr. Kamat treated. I view this as stimulation of the sebaceous glands (which are oil producing just like the meibomian glands).

Personally, my problem is severe underproduction of oil from the meibomian glands so this "stimulation" of all the sebaceous and meibomian glands seems like a good thing to me.

Also, he put me on 5 days of Lotemax and it is really really burning when it goes in and it *seems* like it is drying my eyes out even more than they already were. So I stopped the lotemax. Still don't know if I have any improvement because of this "drying" effect of lotemax.

It is really hard to wait for improvement by the way, because just before the IPl several blood vessels on my eyeball started getting REALLY big and I am afraid they won't go away unless I do something quickly - and IPL is NOT a quick process.

[NeedMyEyes]

My second IPL treament with Dr. Kamat near Philadelphia

Exactly 3 weeks after my first IPL treatment, I returned to Philadelphia to see Dr. Kamat for the second treatment. I was supposed to wait 4 weeks, but some people only wait 3 weeks depending upon the situation.

Dr. Kamat examined my glands this time and said that my TBUT was dramatically improved since last time (it was a 4 last time and now is at least a 6 and maybe more like a 10). Also, while he was checking my glands with a qtip before the procedure he said "I definitely couldn't do this last time you were here..." and I asked what he meant and he said "express your glands like this". He said I have around 25% open with clear oil, 50% completely closed and another 25% making thick goopy yellow-tan stuff.

It sounds like progress but I want to point out that I have done some other things since then - I had the intraductal meibomian gland probing which I think opened some glands. And I stopped using all the drops I am allergic to. So I am not sure which of these interventions is having the beneficial effect. Importanly though, I am improving objectively but not necessarily subjectively - meaning I still feel pretty dry most of the day.

So during this session, the second session, Dr. Kamat turned it up a little bit and this time I did start to feel a little heat with the IPL. On the second pass he finally turned it up to where Dr. Toyos normally starts on the first procedure. So I am a little frustrated by the fact that he is afraid to turn up the power at the early stages, but he is taking a more conservative approach to stay safe and see what is going to happen. I appreciate safety of course, but at the same time, I am soooo in need of relief from these symptoms.

Also, Dr. Kamat always seems to give my drops that make my eyes angry and irritated after the procedure. I think next time I will ask for no drops at all - we'll see what he says.

Dr. Kamat spent more than an hour with me today and answered all my questions and concerns. This session was also on a Saturday and I don't think you will find too many doctors willing to do IPL on a Saturday.

I'll post more updates soon regarding any side effects or any (hopefully) improvement.

Kamat Buck's Eye, Dry Eye, Philadelphia, Meibomian Gland, Dry Eye, Toyos

[Sevenmigirl]

Curious to see how your second treatment has gone? I am considering the same treatment.

[NeedMyEyes]

Well, I am around 2 weeks out from my second treatment and I won't really be able to tell about how I am doing from the IPL because I just got Lipiflow around a week ago. So that is kind of going to mess with the results.

I can say that several more glands have opened up and I honestly don't know for sure, but I think it is from the Lipiflow.

However, I DO plan on going back for my third session with Dr. Kamat. He is a really nice guy and will try to accomodate you as best he can. I can recommend him for IPL from what I know so far. Ask him to use the corneal shields on you for extra protection for your eyes.

If you are going to do IPl, my advice is to get started as soon as possible. The hardest part about IPL is waiting until the next treatment which is always a month since the last one. And you may not get any benefit from the first couple treatments, so that's why I say get started as soon as you can.

Good Luck! Feel free to ask any other questions.

[patrick]

hi,

i'm very curious about your experiences with lipiflow.
since it has been approved here in europe and therefore also available i'm very interested in having this procedure done.
do you know a bit about the results and safety? and how many follow up treatments you normally need before the results begin to show?
i can't find very much information about this particular procedure.

thanks in advance,
patrick...

[NeedMyEyes]

3rd IPL treatment with Dr. Kamat

Just had my third IPL session with Dr. Kamat.

Before the session, he did the usual counting of the glands and measuring the TBUT.

I had 60% open on the left and 80% open on the right. They make normal clear oil. My TBUTs were 8 and 8. I started with 20% open and TBUTs of 4 in each eye.

It's hard to say if this improvement is from the first 2 sessions or if Lipiflow or probing had something to do with it. Personally, I think the most effective so far has been Lipiflow > IPL > Probing. But that's just a guess.

He turned up the settings a bit this time, since I told him I was getting a little impatient with my symptoms.

He even did the UPPER lids this time... He puts steel contacts in my eyes before performing IPL so, I felt like it was a safe procedure. I hope it will open up more of the upper glands.

Oh, and afterwards, he did a pretty thorough expression and he used tweezers to "pop" the additional capped / blocked Meibomian glands.

I started counting the uppers in the mirror and I estimate 80% on the left and not sure abou the left.

I think my Meibomian Glands are getting to the point where an eye doctor won't be able to find any dysfunction unless they knew me from before...

Am I feeling any better? Okay, I guess so. I have been a good bit more comfortable at work recently and don't really use drops that much. Maybe I am just ignoring the pain. Maybe I am just telling myself I feel better because I can see the glands open in the mirror? Not sure.

[Angela]

Just had my third IPL session with Dr. Kamat.

Before the session, he did the usual counting of the glands and measuring the TBUT.

I had 60% open on the left and 80% open on the right. They make normal clear oil. My TBUTs were 8 and 8. I started with 20% open and TBUTs of 4 in each eye.

It's hard to say if this improvement is from the first 2 sessions or if Lipiflow or probing had something to do with it. Personally, I think the most effective so far has been Lipiflow > IPL > Probing. But that's just a guess.

He turned up the settings a bit this time, since I told him I was getting a little impatient with my symptoms.

He even did the UPPER lids this time... He puts steel contacts in my eyes before performing IPL so, I felt like it was a safe procedure. I hope it will open up more of the upper glands.

Oh, and afterwards, he did a pretty thorough expression and he used tweezers to "pop" the additional capped / blocked Meibomian glands.

I started counting the uppers in the mirror and I estimate 80% on the left and not sure abou the left.

I think my Meibomian Glands are getting to the point where an eye doctor won't be able to find any dysfunction unless they knew me from before...

Am I feeling any better? Okay, I guess so. I have been a good bit more comfortable at work recently and don't really use drops that much. Maybe I am just ignoring the pain. Maybe I am just telling myself I feel better because I can see the glands open in the mirror? Not sure.

Wow it is really great to hear that you're feeling better!! I really wish I had the money for Lipiflow because it sounds like it's been a huge help. As for IPL, I have recently emailed Dr. Kamat to inquire about starting treatments with him. After seeing Dr. Bloom in Long Island who told me that he didn't think IPL could help my case, I decided to go to someone who seems like they are willing to try different things depending on the patient. I plan to take a trip out to see Toyos as well, maybe for my 3rd or 4th treatment. After getting your upper lids treated, were they swollen? As you know my main symptom is swelling so this is a huge concern of mine, I don't want to imagine the swelling being even more severe than it is now. But it is my upper lids that are the most troublesome so I wonder if I should take the risk. I am amazed to hear about the state of your Meibomian Glands, it makes me feel really hopeful. How has your swelling been in general since your MGs have improved? What about the Blepharitis (erythematous lid margins, redness, etc.) Oh and doesn't treating the lids directly cause zapping of eyelashes? He'd probaby not consider doing my uppers until a few treatments anyway I gather.

Anyway I am very happy to hear about your success, I hope it only gets better from here.

[NeedMyEyes]

Upper eyelids and swelling

Well, here is what happened:

After the first treatment, I noticed a dramatic decrease in the swelling in the areas he treated. Another poster said somewhere else that happened for them after IPL also.

The swelling goes down in the areas he treats and maybe an inch away also. I forgot that my face used to be thin until I woke up the day afterwards and found all the swelling had gone down.

But then it came back.

A couple months later, I realized I was allergic to my eye drops and stopped using them. So the swelling went away permanently at that point.

But you and I may have different diseases, so you might get different results.

Actually, I think Dr. Kamat will do the upper eyelids for you on the first session if you tell him you are there for the upper eyelids. I remember you said you don't have dry eye and you are really looking for a way to decrease the swelling and MGD in the upper eyelids. So, it would make sense that he will do it.

Oh, and Dr. Kamat uses Corneal Shields made of steel so there is no way the light can reach your iris or your cornea and you have no fear of any damage to those structures.

[Angela]

I wish I could say that I still don't have dry eye...but I can't. I'm pretty sure that I've started to develop it because my eyes feel like there are razors in them and the whites are not so white anymore :/

My biggest fear is the swelling increasing after IPL, I wonder how many people have had that experience?

Dr. Bloom in Long Island told me he doesn't treat the uppers, why is it that some do and some don't? I just want to know how risky it is. I feel like the skin on my eyelids is already so loose and saggy and I'm afraid of it getting worse. I guess I will bring all of this up to Kamat.

Has your lid thickeness improved? In one of your posts you mentioned "thick, beefy eyelids", and I can really identify with that right now...

[NeedMyEyes]

Dr. Kamat is very up front and honest with you about the possible after effects of the IPL. He will tell when he knows and when he doesn't know (and probably no one knows) about the side effects of the procedure.

I personally didn't see any swelling after the procedure at all. I couldn't even tell anything had happened afterwards.

But I do know that everyone's skin react differently to IPL. I have not had a lot of sun exposure in my life and I've read that is a good thing as far as how your skin reacts to IPL. Also, I am a Fitzpatrick type 2.

Oh, on the beefy eyelids - I have no idea if this is the kind of eyes that Dr. Toyos or Dr. Kamat likes to treat with IPL. I don't have those though. That was the weirdest thing about this whole dry eye thing - every doctor said I had "inflammation in my eyelids" - and they didn't look any different than before! My lids eventually got thick with little veins - but I am pretty sure that was an allergic response to my eye drops.

Like I said earlier - the day after my first IPL session, all the swelling in my eyelids that had been there for months disappeared like magic...

I really hope you don't get dry eyes. If you do, I hope you can take care of it as soon as possible.

[Anthony16]

Im happy u are doing well needmyeyes.
I wish these treatments were available in Europe
Dry eye treatment is really really lacking here.
Looking forward to my follow up in New york city next week

Dr. Kamat is very up front and honest with you about the possible after effects of the IPL. He will tell when he knows and when he doesn't know (and probably no one knows) about the side effects of the procedure.

I personally didn't see any swelling after the procedure at all. I couldn't even tell anything had happened afterwards.

But I do know that everyone's skin react differently to IPL. I have not had a lot of sun exposure in my life and I've read that is a good thing as far as how your skin reacts to IPL. Also, I am a Fitzpatrick type 2.

Oh, on the beefy eyelids - I have no idea if this is the kind of eyes that Dr. Toyos or Dr. Kamat likes to treat with IPL. I don't have those though. That was the weirdest thing about this whole dry eye thing - every doctor said I had "inflammation in my eyelids" - and they didn't look any different than before! My lids eventually got thick with little veins - but I am pretty sure that was an allergic response to my eye drops.

Like I said earlier - the day after my first IPL session, all the swelling in my eyelids that had been there for months disappeared like magic...

I really hope you don't get dry eyes. If you do, I hope you can take care of it as soon as possible.

[Angela]

Just going to post here rather than start a new thread..hope that is okay by you NME.

I went to visit Dr. Kamat yesterday morning. His office is in a nice neighborhood, in a small but very comfortable office. He saw me right away and spent about an hour and a half total with me. First he examined my eyes, and confirmed that I have Meibomian Gland Dysfunction. We briefly discussed how this all started with blepharitis and progressed to severe lid swelling and mgd. He used that yellow dye in my eyes and told me that my right eye was worst than my left and that my blinking really wasn't lubricating my eyes much at all. He then used the jumbo qtip to do an expression to find out what kind of secretions I was producing. Like Dr. Latkany, he told me that my glands produce a thick white discharge, some even yellow..no clear oil whatsoever. He also told me that he had to apply a decent amount of pressure to get the gunk out, and that some don't put anything out at all. After this we discussed IPL and the potential benefits that it might have for my case. He told me that it can help reduce the lid inflammation which is the main source of my mgd. He told me that it doesn't happen instantly, I would need several treatments, and there is of course no guarantee that this will help. He was very upfront and honest and I appreciated it.

The treatment:

I decided to have my upper lids done because that is where most of the swelling is (my bottoms are swollen too but not as evident). He told me that this wasn't standard but that if I really wanted it I needed to know that losing eyelashes or eyebrows was a potential risk due to the size of the hand piece. Taking this into consideration, I still went ahead with it. He had to put metal contacts into my eyes for protection. Once they were in, I could not see anything. It was like being blind. My eyes were completely open but I saw black. This gave me anxiety and I told him I was not comfortable. We waited a few seconds until I calmed down and he went ahead with treating my uppers. He only did once pass on each. Afterwards I asked if he could remove them for the rest of the treatment, and he did. He was VERY understanding. The rest of the treatment was easily tolerated, and very quick. It felt like small warm zaps, it was not painful at all for me. Afterwards he did another expression and was honest about it not making a difference secretion wise. That was it. He prescribed Azasite for me and gave me samples of Lotemax eye drops to be used for the next few days. He is a very good doctor and I plan on continuing treatments with him. How do I feel the next day? Not much different but at least I begun treatments. I was hoping that I'd see a reduction in my lid swelling but there is no change.

[NeedMyEyes]

Toyos videos on Youtube!

Hi, Angela. Of course post away. It gets lonely on a thread when I am the only poster ;-) Wait, so he only did the upper eyelids? Not the lower ones?

Dr. Toyos just posted these videos on Youtube about a month ago:

[Angela]

NOOOOO he totally did the lower ones too lol. He just one pass on each of the uppers and then I needed to take the contacts out so he put the sticky shields on and did 2 passes on each of the lowers.

Woah those videos are something else. Honestly if I didn't have this condition I would probably be disgusted but I'm actually thrilled to see so much stuff come out of the MGS haha. Looks like very thorough expressions too. The first one is like something out of a sci-fi special. Those secretions are probably what mine look like because I get those stringy things just from washing my face or rubbing my eye.

I really wish I was feeling better but I don't feel any difference after the first treatment which I'm sure is common. Actually my upper eyelids look even more purple swollen and saggy =( I really think I have something else going on too because I am getting really thick white discharge coming out of my nose and my breathing and headaches are worse. Kamat told me I should follow up with another ENT but I can't afford to be going to millions of different doctors.