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  • LipiFlow Information

    Hi,
    I just thought I would pass this along, I recieve in the mail today a flyer from the Jules Stein Eye Institute at UCLA where I had been seen in the past for my post LASIK mess. They are now offering the "LipiView Ocular Surface Imaging System" and "LipiFlow Thermal Pulsation" for dry eye sufferers by Dr. Rex Hamilton at the UCLA Laser Refractive Center. The cost is $150.00 for the analysis and $750.00 per eye for the treatment. I have never had it, I have had 6 IPL treatments so I figure it probably won't help me anyway but I am thinking this is pretty expensive, also they are claiming to be the first in the western US to offer this treatment. I thought some of the people on this board have tried it and if so, what was the outcome and how much did it cost? Take care.

    Brad

  • #2
    I got LipiView done in Richmond BC Canada. Here's their website: http://www.central-eye.com/dryeye.html.

    As far as I recall it cost either $110 or $120 + tax. It was one or the other I'm pretty sure.

    For the LipiFlow I think it was $900 for one eye and $1500 for both (although I never got this done since I couldn't afford it).

    Comment


    • #3
      Brad, I'll try and respond to your inquiry regarding Lipiflow afer IPL. So far I have completed 4 IPL treatments in Charlotte, NC by a doctor trained by Dr. Toyos. I also had the Lipiflow performed at Duke Medical eye center a few days ago. The treatment is $1500.00 for both eyes and includes the Lipiview.

      Upon completing the IPL treatments, the doctor informed me that the glands were performing a whole lot better and the oil secretions were clear and liquid. Great news, right! Sypmtoms have not improved at all though. I should also mention that the treatments were very intense and lots of squeezing going on. The heat generated is also intense and following each IPL treatment I had lot of oil secretions form around my eyelashes in the morning and mucous film throught the day. After the 4th treatment, less mucous formed and the oils became clearer. To me that is good news when oils form around eyelashes in the morning. Short lived though.

      Now Lipiflow. The doctor (corneal specialist and involved in lipiflow research) said my glands were still blocked and my lipiview numbers were really low (average 40-45). He pressed gently on my glands with a tool that exerts the same pressure as a natural blink and found that I had less than 6 glands excreting. That was done on the lowers and not the uppers. Did not do anything to the uppers. Of course, I continued with the Lipflow.

      The procedure lasts 12 minutes and it is a flickering motion with mild heat. Not uncomfortable at all. However, in my opinion, the heat generated and the massaging effect is so mild I did not expect it was doing a whole lot. Again in my opinion, the squeezing performed by the IPL doctor is far more intense than anthing lipiflow will ever accomplish and the heat generated from IPL is far more intense. Also while the doctor expresses your glands, he/she is doing it under the slit lamp and basically sees what is going on and pushes against the glands until clear oils are coming out. With the lipiflow, you just have to believe the junk and thick secretions are being pushed out but you really never know.

      After the procedure, I felt nothing and went home after 2 hour drive. I woke up next morning and no mucous or oil forming around my eyelashes. In fact, my eyes did not feel different at all. I know I was told to wait a few weeks for the full benefit, but I am skeptical I will feel the improvement later.

      I am to return 3 months later for the lipview evaluation and from there decide the frequency of the treatments.

      Here is my opinion and only my opinion:
      I basically wasted $1500.00 on lipiview and possibly 4 IPL treatments @ $375.00 each. I discussed my thoughts with the lipiflow doctor and he agreed with everything I said concerning meibomian gland disease. Here is what I think:
      If your oils are thick and glands get clogged, then any treatment you perform such as IPL, probing, lipiflow is very temporary. It may improve your symtoms for a short while but in the end your oil secretions will revert back to how they were since it is genetically controlled and possibly under hormonal influence.

      So before you spend lots of money on the above, have a doctor who knows what he/she is doing express you glands after heat application. Check if you feel any improvement and for how long. Chances are that will give you somwewhat an indication whether it is worth it to undergo the "fancy" treatments.

      In the end, all the treatments are similar since their purpose it to squeeze out the junk in the oil glands and really how it is accomplished I believe makes no difference.

      Of course, I know several of you may disagree but I have put a lot of thought into this.

      Comment


      • #4
        Chemia,
        It's so good of you to take the time to share your experiences and I completly understand your going ahead with the lipiflow treatment despite reservations- All we all want is relief from this plague. It's infuriating that one doctor will tell you your glands are open and functioning and the next says they're not- I've been thru this just going from one opth to another and it's like WTH? Are they or aren't they? I'm disappointed to read that you haven't had a real change in your condition with the lipiflow though, as I was hoping that would be the "magic gloop" that could really help us. I've never even been able to get a doctor to express my glands for me- I get the usual instruction about warm compress and massage, which really seem to make me worse and I begin to think that maybe I just don't produce enough oil. I do hope you'll post again after some time has gone by and perhaps things will have improved.

        Comment


        • #5
          Brad,

          From what I understand, Lipiflow reaches the upper glands too, not just the lowers. Did your IPL treatments ever reach the uppers? Mine did not and that always left me kinda skeptical.

          I guess what I am getting at is that Lipiflow might be worth looking into because the uppers could be 50% of the problem. I will be researching it furiously until it arrives in Florida.

          Sorry to Chemia about the lack of relief after spending all of that money though... I agree that with IPL you get to see the gunk. Seeing it was, for me, a validation of sorts that I did have a reason to feel this way.

          FYI to all though - I asked a local dry eye guy who I've been seeing how long it will take for Lipiflow to be covered by insurance and he said since it already has FDA approval, it might only take a couple of years. Woooooot!

          Rose

          Comment


          • #6
            Lipiflow does reach the uppers but I can tell you for a fact that the heat and massaging action is too mild in my opinion to make a difference. The lowers by the way hardly feel anything and was confirmed by the doctor since I made the remark that I feel the action only on the uppers.
            When I had the IPL done, I felt more heat on my uppers merely from the IPL wand being directed around the face especially around my temples and nose area. My doctor dids also express my uppers manually.

            Comment


            • #7
              Chemia,
              I'm wondering if, once the mebomian glands are open, if going on doxy for a while would help keep things flowing?

              Comment


              • #8
                I specifically asked the Dr. about that and he told me he discourages long term use of doxycycline due to potential long term side effects and mentioned to me how his colleague got admitted to ICU from doxycycline. He suggested azasite one month on and 2 months off for a while.
                I should also mention I have tried doxy twice and could not handle the heartburn, loss of apetite and other issues I developed.
                My dermatologist is the one who actually requested I stop the doxycycline when I mentioned my heart burn situation and gave me quite a scare when I was told continued heartburn and ulcers from antibiotics could eventually lead to esopgageal cancer.
                To be honest, I never benefited from doxycycline and so really it was doing more harm than good.
                I may start azasite but I know I tried it in the past and had no luck.

                Comment


                • #9
                  Here's a little chart of my LipiView scores.



                  I have another appointment for LipiView in January.
                  Last edited by spmcc; 15-Dec-2011, 17:10. Reason: added more detail to the chart

                  Comment


                  • #10
                    Hi All,
                    Thank you for the replies. I tend to agree Chemia, the IPL along with the aggressive gland expression seems more beneficial. I however never felt any better even after 6 IPL treatments one month apart. I just received word to day that a resident I have been seeing has finally gotten approval through the college for autologous (sp) serum, I will be starting that in January and I will be involved in study as well.

                    On another note, the college is the Southern California School of Optometry, I initially went there for sclera lens fitting, and the total cost would have been under $1000.00 which is a fraction of BFS. In fact I had tried earlier in the year for a fitting at the Doheney Eye Institute at USC and the Dr. was a resident at the same college! In fact, the Dr I now see took her place and they dispense all of the same brands and style of sclera lenses. They tell me they treat many post-LASIK dry eye and ectasia patients.

                    Comment


                    • #11
                      I also wanted to ask, spmcc, are you feeling any better? Are you a post LASIK? And I could not wear the sclera lens, way too much pain and I forgot to mention that cost me $600.00 for the fitting and would have cost nearly $10,000 if I had gotten the lenses, in contrast, the SCSO was $75.00 for the fitting! Sadly I failed both attemps

                      Comment


                      • #12
                        Originally posted by jimi51 View Post
                        I also wanted to ask, spmcc, are you feeling any better? Are you a post LASIK? And I could not wear the sclera lens, way too much pain and I forgot to mention that cost me $600.00 for the fitting and would have cost nearly $10,000 if I had gotten the lenses, in contrast, the SCSO was $75.00 for the fitting! Sadly I failed both attemps
                        Yes, I'm feeling better... but I am cautiously optimistic (as everyone is who has suffered from this for years and had many failures).

                        I should explain that I've been on a blitz the last ~2 years. I had 4 IPL treatments specifically for dry eyes, two probing with Maskin, all puncta sealed (3 cauterized and 1 sutured), and now two LipiFlow treatments. I also wear Wileys ALL day and seal my eyes at night.

                        I also tried sclerals in 2009. They weren't for me.

                        IMHO, LipiFlow has been the best treatment for me so far (along with having all puncta sealed and wearing Wileys). I would rank it above IPL and certainly above probing for MGD treatment.

                        BTW I have never had Lasik or any other refractive surgery. My diagnosis is ocular rosacea since 1995.

                        Comment


                        • #13
                          Originally posted by spmcc View Post
                          Here's a little chart of my LipiView scores.

                          [ATTACH]367[/ATTACH]

                          I have another appointment for LipiView in January.
                          Thanks for sharing the graph. Very useful information. Are the July readings pre-treatment? When I look at the readings I see minimal change from July to November with a decent change in the left eye from 46 to 57 but could also be due to the high SD (standard deviation of the test) more than the actual improvement. Just a thought. I was told that in order for the test to be considered a success, the lipid thickness should be double what is was originally.

                          Comment


                          • #14
                            Originally posted by Chemia View Post
                            Thanks for sharing the graph. Very useful information. Are the July readings pre-treatment? When I look at the readings I see minimal change from July to November with a decent change in the left eye from 46 to 57 but could also be due to the high SD (standard deviation of the test) more than the actual improvement. Just a thought. I was told that in order for the test to be considered a success, the lipid thickness should be double what is was originally.
                            Yes, the readings are pre-treatment. They wouldn't take readings right after treatment because they don't expect a huge jump right after or even a few weeks later.

                            I didn't include any info on the standard deviations. If you want them, July 9 OD was 3, OS 4; Aug 25 OD was 10, OS 12; Nov 23 OD was 3, OS 4.

                            I've never heard about any promise of doubling lipid layer thicknesses. Sounds suspect!

                            I think patience is key.

                            Comment


                            • #15
                              Sheila,

                              As always you are a wealth of information. Could you answer a question for me by chance - if someone wanted to go get Lipiflow once a week, would they allow you to do it? Say, cost was no issue and you just wanted to empty those glands?

                              Rose

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