How often can you have lipiflow?

[Guest]

Just wondering how long I should wait for another lipiflow? It helped a bit so I think another would help more.

I'm assuming the machine doesn't pressure the glands enough to damage them - at least I found it way less painful then having my glands squeezed manually!

[deep_dry_eye]

I've had it once every 3 months before, I stopped. I find IPL to be way more effective. IPL has a chance to tackle the underlying inflammation, while LipiFlow just clears the glands.

[Guest]

You have to find the correct treatment to solve the underlying problem. Lipiflow is just a sexy hot compress. I would ask your doctor how often they would let you do it or better yet, call the manufacturer.

https://tearscience.com/

The problem however, is that the glands will just keep clogging if you don’t treat the main cause. I’ll use myself as an example. I have floppy eyelid syndrome, it presents as advanced MGD, but if I treat it that way, the problem will not resolve. I have to treat the chronic papillary conjunctivitis to get the oil flowing again. That’s a much different treatment plan than what I was originally on. Neither lipiflow or ipl would have helped me.

So my point is, I’m not sure what your diagnosis is, but you may want another opinion. What is your diagnosis and what’s your current regimen aside from the lipiflow?

Ipl only tackes the root cause of your problem is rosacea. Because in that case, it will shrink the blood vessels supplying the inflammatory markers to the lid. It may help people without rosacea, but it’s not tackling the root cause. It’s a band aid at best, just like lipiflow. I’ve never heard of a single person doing lipiflow and being healed. But if it offers relief while you’re trying to sort out your issues, use it. This is just my opinion on lipiflow and ipl based on my research of the literature and anecdotal accounts of members here.

[Milo007]

I've had it once every 3 months before, I stopped. I find IPL to be way more effective. IPL has a chance to tackle the underlying inflammation, while LipiFlow just clears the glands.

Agree 100%. IPL followed by manual expression is more effective than lipiflow. IPL controls inflammation, liquifies the meibum and stimulates the meibomian glands to produce more lipids. A manual expression would steer the stagnant secretions after an IPL procedure so I don't see in what way lipiflow does something different or in a better way.

[Guest]

IPL isn't helping. Lipiflow did in the past. I have no idea why, except it seemed to unclog my glands much better than manual expression. I know they'll clog again but I've tried everything to stop that and nothing helps. Winter weather has been aweful.

Thanks deep_dry_eye every three months sounds reasonable.

[deep_dry_eye]

IPL isn't helping. Lipiflow did in the past. I have no idea why, except it seemed to unclog my glands much better than manual expression. I know they'll clog again but I've tried everything to stop that and nothing helps. Winter weather has been aweful.

Thanks deep_dry_eye every three months sounds reasonable.

Where did you get your IPL? I've recently found out not all IPL protocols are the same. I switched from the Dr Toyos IPL protocol to Dr Periman IPL protocol, and I noticed a big difference. The main difference is that Dr Periman does both the uppers and lowers (while Toyos only does the lowers), also the energy level is different.

[Topher3]

Agree 100%. IPL followed by manual expression is more effective than lipiflow. IPL controls inflammation, liquifies the meibum and stimulates the meibomian glands to produce more lipids. A manual expression would steer the stagnant secretions after an IPL procedure so I don't see in what way lipiflow does something different or in a better way.

It’s because lipiflow can actually heat the meibomian glands from the inside through the thin membrane. It’s very hard to heat the meibomian glands evenly and to a sufficient temperature PROPERLY and then express the oils out. Because as soon as the the heated towel/blephasteam/heat goggles come off the eyes every second the optometrist/dr waits before expressing, the oils are already hardening. Lipiflow heats the oil while it’s continuously expressing the glands for a whole 12 minutes. Lipiflow is better at it, however does not have the antibacterial impulse light advantage.

Both are are good I believe you should do lipiflow followed by ipl personally for maximum results. Always express after IPL or it’s pointless...

[hopeful_hiker]

Lena11, I just did a second one, so four months apart. I have some IPL as well. I think all of the methods help each other. The only one I would be worried of is probing. But then again, some people had success with that. In my case the glands on the Keratograph were looking fat but not atrophied so the Lipiflow made sense.

[Milo007]

It’s because lipiflow can actually heat the meibomian glands from the inside through the thin membrane. It’s very hard to heat the meibomian glands evenly and to a sufficient temperature PROPERLY and then express the oils out. Because as soon as the the heated towel/blephasteam/heat goggles come off the eyes every second the optometrist/dr waits before expressing, the oils are already hardening. Lipiflow heats the oil while it’s continuously expressing the glands for a whole 12 minutes. Lipiflow is better at it, however does not have the antibacterial impulse light advantage.

I am not completely convinced with this claim because I saw some videos of IPL by Dr. Toyos where he performed a session of IPL on a patient and he performed a manual expression immediately following the procedure which clearly showed runny pasty kind of secretions pop out of the meibomian gland orifices. This confirms that IPL followed by manual expression flushes out the contents of the glands. However, your point could be relevant if we consider the complete length of the meibomian glands. It's possible that the lipids in the distant portion of the meibomian glands harden within a few seconds after the IPL treatment and a manual expression even if performed within a minute wouldn't flush out the stagnant secretions completely. Again this is a theory and we need to correlate to patient experiences.

It would be interesting to hear from people who have had both LipiFlow and IPL (preferably IPL with no or little success followed by lipiflow with significant benefit). I always thought Tearscience was pushing lipiflow more aggressively with its marketing and IPL was equally or more effective.

Have you personally had more benefit from lipiflow than IPL?

Both are are good I believe you should do lipiflow followed by ipl personally for maximum results. Always express after IPL or it’s pointless...

Cost is the real downside of lipiflow otherwise it would have been the first choice of a complimentary procedure along with IPL.

You made an excellent point that IPL must be followed by manual expression. My opthalmologist totally ignored this fact. It's irritating to be honest.

[Topher3]

I am not completely convinced with this claim because I saw some videos of IPL by Dr. Toyos where he performed a session of IPL on a patient and he performed a manual expression immediately following the procedure which clearly showed runny pasty kind of secretions pop out of the meibomian gland orifices. This confirms that IPL followed by manual expression flushes out the contents of the glands. However, your point could be relevant if we consider the complete length of the meibomian glands. It's possible that the lipids in the distant portion of the meibomian glands harden within a few seconds after the IPL treatment and a manual expression even if performed within a minute wouldn't flush out the stagnant secretions completely. Again this is a theory and we need to correlate to patient experiences.

It would be interesting to hear from people who have had both LipiFlow and IPL (preferably IPL with no or little success followed by lipiflow with significant benefit). I always thought Tearscience was pushing lipiflow more aggressively with its marketing and IPL was equally or more effective.

Have you personally had more benefit from lipiflow than IPL?



Cost is the real downside of lipiflow otherwise it would have been the first choice of a complimentary procedure along with IPL.

You made an excellent point that IPL must be followed by manual expression. My opthalmologist totally ignored this fact. It's irritating to be honest.

i have had both ipl and lipiflow, to be honest my ipl was not done properly they expressed before hand which was a complete waste of my time and money, lipiflow has helped I believe but I’m still not at a place where I’m comfortable. I will be doin ipl again but I will call and find a place that does the expressing after impulse light.also I don’t know why some don’t bother to express upper glands, why wouldn’t you want to express the 50% of people’s eyes, baffles me.

[Milo007]

i have had both ipl and lipiflow, to be honest my ipl was not done properly they expressed before hand which was a complete waste of my time and money, lipiflow has helped I believe but I’m still not at a place where I’m comfortable. I will be doin ipl again but I will call and find a place that does the expressing after impulse light.also I don’t know why some don’t bother to express upper glands, why wouldn’t you want to express the 50% of people’s eyes, baffles me.

It's obvious opthalmologists need a more uniform protocol of treatment that which works the best. Your opthalmologist expressed glands before IPL. Mine didn't even care to express the glands. And we are helplessly accepting the fact that our glands are perhaps getting damaged further with each passing day. Horrible thoughts.

[Guest]

Milo007 My doctor filmed the expression so I could see little yellow droplets coming out the glands. I think they must be clogged deep inside as my oil layer thickness is 25 so incredibly low.

It's weird as the oil she filmed wasnt anything like white toothpaste so I don't really understand why my oil layer is so low.

[Milo007]

Milo007 My doctor filmed the expression so I could see little yellow droplets coming out the glands. I think they must be clogged deep inside as my oil layer thickness is 25 so incredibly low.

It's weird as the oil she filmed wasnt anything like white toothpaste so I don't really understand why my oil layer is so low.

I think in your case the lipids were not too hard before the IPL procedure so after the IPL therapy the lipids melted to almost a liquid texture which was yellowish. The lipids being yellowish confirms the fact that the lipids were stagnant inside the glands for sometime. Had it not been stagnant it would have been colorless and of the texture of olive oil before expression. Had it been stagnant for too long the texture of the secretions after the IPL procedure would have been pasty and whitish in color.

Have you been able to manually express lipids after a warm compress followed by finger massage?

I think you should perform warm compress (twice daily)diligently on a daily basis and try to express the lipids using fingers or a q-tip. You should also perform blink exercises every two hours for 5 minutes each time. Perhaps you should also be on topical azithromycin and oral doxycycline for a month (if you can tolerate doxycycline). See if it breaks the vicious cycle and your LLT improves after a month.

Get a pair of moisture chamber glasses (I believe it is very important) as soon as possible and make it a habit to wear them all time atleast for the next 3 months. My hypothesis is doing all these things together could break the cycle of inflammation-stagnation-blockage providing tear film stability and time for your eyes to heal.

[MGD1701]

My doctor filmed the expression so I could see little yellow droplets coming out the glands. I think they must be clogged deep inside as my oil layer thickness is 25 so incredibly low.
It's weird as the oil she filmed wasnt anything like white toothpaste so I don't really understand why my oil layer is so low.

Hi Lena, Any idea
how many glands are open? any capping?
inflammation issue (did doctor check this, if so, how? MMP-9 is more accurate and can detect more things.

Do you mean such lilttle yellow droplets are both lower and upper lids?
your eyes must be very dry since lipid layer only 25? if not, maybe 25 is incorrect??

[Guest]

MGD1701 My doctor told me MMP-9 is pretty useless. E.g. she has no dry eye and tested it on herself and her score was really high, whereas a friend with really bad dry eye had a very low score. They've stopped using it.

Everyone tells me my glands look quite good but yes I think 25 is accurate - I've had it measure with another machine that said 30. My eyes have a tbut of about 4 and feel very dry.