IPL, my experience

[deep_dry_eye]

Yes, I am on Xiidra and my Dr seemed amazed at how I have zero inflammation on the surface of my cornea. Xiidra seem to be working for me on that front which may help treatments to be effective (vs undergoing treatment with inflammation on the eye).

You can consider adding Restasis on top. I am on both simultaneously. I do firmly believe both drugs to have a different mechanism of action, and they can work together to reduce inflammation.

[phenix01]

Hi phenix
Great. Do you mean you have corneal inflammation prior to IPL?
TBUT: also improved from 3 seconds?

I'm sure I had inflammation at some point but prior to doing IPL I had no inflammation despite a TBU <3s. Dr didn't check my TBU on my appointment for 2nd treatment. Perhaps it's too soon.

[deep_dry_eye]

I'm sure I had inflammation at some point but prior to doing IPL I had no inflammation despite a TBU <3s. Dr didn't check my TBU on my appointment for 2nd treatment. Perhaps it's too soon.

Just to be clear, when I said inflammation, I meant inflammation of the meibomian glands (as opposed to cornea or other parts of the ocular surface). It is difficult and maybe even impossible with Today's technology to properly diagnose whether there is inflammation inside the glands.

[ebi1368]

You can consider adding Restasis on top. I am on both simultaneously. I do firmly believe both drugs to have a different mechanism of action, and they can work together to reduce inflammation.

I am finding temporary relief from Xiidra. I got headaches from restasis. Have you heard anyone using Xiidra more than twice a day?

[MGD1701]

Thanks Phenix.
Just curious, how did your doctor detect corneal inflammation, with dye?
Do you/your doctor consider xiidra help with such inflammation? if not, what then?

[deep_dry_eye]

I am finding temporary relief from Xiidra. I got headaches from restasis. Have you heard anyone using Xiidra more than twice a day?

I am in talks w/ my Dr about it. The rationality is simple, Xiidra is such an effective drug (esp over Restasis), however half-life is estimated to be less than 1 hour. It makes sense to have more frequent dosages of Xiidra. In fact, the original Xiidra trials were done 3 (maybe even 4 times) a day. The reason they settle for 2 is because of compliance, its easier to sell a drug to both consumers and FDA if it only needs to be used twice a day.

[deep_dry_eye]

Thanks Phenix.
Just curious, how did your doctor detect corneal inflammation, with dye?
Do you/your doctor consider xiidra help with such inflammation? if not, what then?

My understanding is that corneal inflammation can be usually seen under the scope, w/ or w/o staining. Usually the way to fix it is to fundamentally fix the underlying dry eyes. Steriods are commonly prescribed however can not be used long term. I am unsure about the efficacy of Xiidra or Restasis on the Cornea. However, Prokera fixed a lot of the staining and SLK in my eye though.

[phenix01]

Just to be clear, when I said inflammation, I meant inflammation of the meibomian glands (as opposed to cornea or other parts of the ocular surface). It is difficult and maybe even impossible with Today's technology to properly diagnose whether there is inflammation inside the glands.

Correct, truth is doctors can't accurately pinpoint what causes MGD. It could be inflammation within the glands, bacteria, poor blinking... it's trial an error with different treatments to see what works and infer diagnostics.

And yes you need ot fix the underlying dry eye problem to fix corneal inflammation long term. Xiidra is just a "fix", fixing it short term to help MGD treatment work better. Xiidra may help against gland inflammation too but I seriously doubt it.

[phenix01]

Thanks Phenix.
Just curious, how did your doctor detect corneal inflammation, with dye?
Do you/your doctor consider xiidra help with such inflammation? if not, what then?

Yes som instrument he applied on my cornea. He believes xiidra is the reason why I do not have inflammation on my cornea although my eyes are dry. Xiidra is essentially a "fix".

[phenix01]

Not much improvement from treatment #1 to treatment #2. It's always great right after treatment for a week bu so far nothing sustained. Getting treatment #3 in two days..

[deep_dry_eye]

Not much improvement from treatment #1 to treatment #2. It's always great right after treatment for a week bu so far nothing sustained. Getting treatment #3 in two days..

good luck! pls keep us posted

[phenix01]

UPDATE (one week after 3rd treatment)

Just like with the first two treatments, first week post 3rd treatment was good, then it comes back to not producing much oil (at least that's what it feels like). I'm strating to be out of solutions here. My doc says I have good oil osmolarity and that I'm responding well to the treatment, yet it still feels like not enough oil is getting out of my glands. Dr will increase pulse strength on my lids for 4th treatment, but I'm starting to lose hope here.

[MGD1701]

Thanks for sharing. What are your lipid layer thickness, 3 main complaints?
how many glands are opened?
Did doctor take MMP-9, osmolarity? which can also rule out like CCH, allergy etc.

[ebi1368]

UPDATE (one week after 3rd treatment)

Just like with the first two treatments, first week post 3rd treatment was good, then it comes back to not producing much oil (at least that's what it feels like). I'm strating to be out of solutions here. My doc says I have good oil osmolarity and that I'm responding well to the treatment, yet it still feels like not enough oil is getting out of my glands. Dr will increase pulse strength on my lids for 4th treatment, but I'm starting to lose hope here.

Do you have upper and lower plugs?

[phenix01]

Thanks for sharing. What are your lipid layer thickness, 3 main complaints?
how many glands are opened?
Did doctor take MMP-9, osmolarity? which can also rule out like CCH, allergy etc.

Not sure about lipid layer thickness. Regarding amount of glands open, it depends which doctor I ask. One recently told me my glands are generally all producing but in low quantity.
Dr did take inflammation which resulted in no inflammation on the surface of the cornea (I use xiidra), and confirmed that osmolarity is good.

Is it plausible to obtain relief only after 4+ treatments?