My experience with Lipiflow in Toronto

[spmcc]

Hi SAAG,

I had IPL on my upper lids a number of times and the dermatologist used "metal contacts" to protect my eyes. And, just as you imagined, the contacts stuck to my eyes (Schirmer's of zero in both). The dermatologist used drops I carry in my purse and after some weird manipulations to un-do the suction, one at a time, they came out. But there were definitely some awkward moments (I was laughing because I imagined my life with permanent metal contacts).

I will say that prior to Lipiflow (I have my appointment on July 9), Herzig Eye told me:

Please do not use any natural tears 4 hours prior to your visit, no ointments 24 hours prior to your visit, refrain from restasis for 24 hours prior to your visit and no makeup.

However, as NeedMyEyes writes, I'm sure that they'll take care to make sure the experience isn't too upsetting.

Cheers,
Sheila

[SAAG]

Well, I'm glad to hear that you survived the contacts sticking... whew! Please post about how the Lipiflow goes... I'm tempted to give it a try myself...

And thanks for your feedback as well NeedMyEyes!

[NeedMyEyes]

Well, to respond to Sheila's comment: Metal contacts have a smooth, hard surface and I can imagine they would definitely stick to the eyeball.

However, this is rubber contact made of a very eye-friendly material. It doesn't hurt at all. And with a few drops of saline in the eye, I just can't imagine you would have any problems with "drying out" in those 12 minutes. It was a very comfortable procedure - and after getting my glands expressed and also getting IPL, I was assuming something had to be painful to be as effective as Lipiflow.

SAAG, I was worried about allowing more chronic damage to my glands. So I just decided to go get it done asap.

NME

[spmcc]

I just wanted to report that I went to Toronto last weekend to have LipiFlow on Saturday July 9.

It's exactly as I heard... completely innocuous, completely comfortable to have done... just a little weird sensation as it "massages" your lids. The heat (43*) that is produced didn't cause a rosacea flare or discomfort. I was 100% certain that my face would flush and become painful, but the heat is very concentrated on the lids and was tolerable to me (who is hyper-sensitive). The only "bad" part about the whole experience was The Usual... drops and dyes (dye for the exam and anesthetic drops for the procedure). Drops and dyes always make my eyes worse for a day.

Anyway, before I went I was very interested in LipiView and the pre-treatment evaluation. It's pretty cool... they take a 20-second video of you blinking and they slow it down and show you! Dr. Patel explained that blinking creates a zipper-like effect where your lids meet and squeeze out the oils from the lower lids. Then the upper lids distribute the oils. So, if the lids don't meet, no oil comes out and certainly no oil is distributed on the surface.

I also learned that partial blinking is very common in people with dry eyes. Dr. Patel gave me instructions on blinking exercises.

I found that LipiView (and the whole pre-treatment exam) was very similar to my experience with IPL for dry eyes. Both concentrate ONLY on the LOWER meibomian glands. Dr. Patel counts the ones working, the quality of oil produced and whether any are atrophied/dead.

Dr. Patel also explained that the meibomian glands on the lower lids toward the NASAL FISSURE (approx 6 glands on each side) have been shown to be the most important for oil production and comfort.

LipiView also has its own "rating" system. I was told anything below 50 means you have problems with oil. My right eye (worse eye) was 38 and my left eye was 43. I'm interested in comparing scores with other people!

I have to say that I didn't mention anything about "a worse eye" before the exam so I was impressed that the device caught it. No other doctor or test has been able to confirm that. My eyes are usually mirror-images with regards to standard tests (Schirmer's, TBUTs, etc.).

After LipiView and slit lamp evaluation, you go to another room to have LipiFlow. LipiFlow treats both the upper and lower lids at the same time. The treatment itself takes only 12 minutes in total. The whole appointment took approx 1 hour.

I was told NOT to expect to see/feel any results for 2-4 weeks. In other communications, I was told 4-6 weeks.

[Anthony16]

Plz let us know how u get on.
Thanks

I just wanted to report that I went to Toronto last weekend to have LipiFlow on Saturday July 9.

It's exactly as I heard... completely innocuous, completely comfortable to have done... just a little weird sensation as it "massages" your lids. The heat (43*) that is produced didn't cause a rosacea flare or discomfort. I was 100% certain that my face would flush and become painful, but the heat is very concentrated on the lids and was tolerable to me (who is hyper-sensitive). The only "bad" part about the whole experience was The Usual... drops and dyes (dye for the exam and anesthetic drops for the procedure). Drops and dyes always make my eyes worse for a day.

Anyway, before I went I was very interested in LipiView and the pre-treatment evaluation. It's pretty cool... they take a 20-second video of you blinking and they slow it down and show you! Dr. Patel explained that blinking creates a zipper-like effect where your lids meet and squeeze out the oils from the lower lids. Then the upper lids distribute the oils. So, if the lids don't meet, no oil comes out and certainly no oil is distributed on the surface.

I also learned that partial blinking is very common in people with dry eyes. Dr. Patel gave me instructions on blinking exercises.

I found that LipiView (and the whole pre-treatment exam) was very similar to my experience with IPL for dry eyes. Both concentrate ONLY on the LOWER meibomian glands. Dr. Patel counts the ones working, the quality of oil produced and whether any are atrophied/dead.

Dr. Patel also explained that the meibomian glands on the lower lids toward the NASAL FISSURE (approx 6 glands on each side) have been shown to be the most important for oil production and comfort.

LipiView also has its own "rating" system. I was told anything below 50 means you have problems with oil. My right eye (worse eye) was 38 and my left eye was 43. I'm interested in comparing scores with other people!

I have to say that I didn't mention anything about "a worse eye" before the exam so I was impressed that the device caught it. No other doctor or test has been able to confirm that. My eyes are usually mirror-images with regards to standard tests (Schirmer's, TBUTs, etc.).

After LipiView and slit lamp evaluation, you go to another room to have LipiFlow. LipiFlow treats both the upper and lower lids at the same time. The treatment itself takes only 12 minutes in total. The whole appointment took approx 1 hour.

I was told NOT to expect to see/feel any results for 2-4 weeks. In other communications, I was told 4-6 weeks.

[jenny2008]

wow.. thanks! i had probing done 3 x and it would help but not a long duration as my doc had hoped. he was trained by Dr. Maskin in doing the procedure so like you i knew he absolutely knew what he was doing..

i will be anxious to see what others say about lipiflow and i wonder where in the U.S. it will be done??

[spmcc]

I had LipiFlow in Toronto on July 9, 2011 (see my post: .http://www.dryeyezone.com/talk/showt...ght=#post63012)

My first follow-up was in Abbotsford, BC on Aug 25, 2011 (just shy of 7 weeks after treatment).

My LipiView scores have increased slightly. In July, my lipid layer thickness measured 38nm OD and 43nm OS. Two days ago, I was 40 OD and 46 OS.

I was told that anything less than 50nm is considered "severe".

Unfortunately, I don't *feel* improved. I was asked to come back in a month for another measurement and I'm considering having another treatment.

[Chemia]

Thanks for keeping us upated on your results. However, I find the increase minimal and possibly due to the expected standard deviation of the measurement itself. I would think the tear thickness could also change a couple of nm throughout the day depending on environmental conditions, computer use and such. I would consider an icrease of 10nm if that's possible an appreciable change. It's unfortunate you don't feel the improvement though. I am in the same boat; did a couple of IPL treatments by a Dr trained by the Toyos procedure but feel no improvement at all even though the oils are moving better.

[SAAG]

I had LipiFlow in Toronto on July 9, 2011 (see my post: .http://www.dryeyezone.com/talk/showt...ght=#post63012)

My first follow-up was in Abbotsford, BC on Aug 25, 2011 (just shy of 7 weeks after treatment).

My LipiView scores have increased slightly. In July, my lipid layer thickness measured 38nm OD and 43nm OS. Two days ago, I was 40 OD and 46 OS.

I was told that anything less than 50nm is considered "severe".

Unfortunately, I don't *feel* improved. I was asked to come back in a month for another measurement and I'm considering having another treatment.

Thanks for the update! I'm sorry to hear that you're not feeling any improvements though...

[shirley]

I, may sound like I'm playing the devil's advocate - but after the disastrous "almost 100% safe" neurosurgery I had which resulted in, amongst other awful complications, severe DES, RCEs, and then suddenly I also found out I had EBMD and MGD which are unrelated to the neurosurgery...I do not believe any procedure is without risk. I did not think that before my surgery, but believed I had no choice but to take the risk. (The recent neurosurgery had nothing to do w/eyes, was due to a botched emergency neurosurgery 23 yrs ago for something totally nonrelated). Taking or applying any drug, herbal supplement, etc. has risks. I will wait a considerable time until I see at least several years of trials, research, before I trust the vision I have left to a new technique. I'm not negative, just much more cautious at this point.

Maria

I do find it suspect that these procedures are not in controlled, double blind studies, with an ophthalmologist as principal investigator. The websites seem more sensational, rather than reliable. As I read all the posts, it really seems that there is little significant improvement, and a lot of money spent.
Be careful. And regarding LASIK surgery, which has been mentioned along the way,
if you go to the dryeyezone website, you find that many on that site had major complications after LASIK, one of them frequently mentioned, are dry eyes.
But I am a cynic and a skeptic, so very reluctant about all if this.

[blessings]

hello! I noticed that you posted that you had lipiflow at Duke by Dr. Carlson. Did you get any relief? I am new at postiing. This message was for Chemia

[blessings]

This message is for Chemia.
Did you find any relief from lipiflow at Duke by Dr. Carlson?

[Chemia]

Blessings, I did not get much benefit from the lipiflow treatment. As I mentioned in an earlier post, my lipiview numbers after 1 month and 3 months after lipiflow did not show any increase whatsoever. In one eye, it was actually lower. This could be due to the standard deviation of the test itself. My symptoms never improved either and although my glands started to funtion better, it lasted for a couple of weeks before I was back to the normal clogged glands with thick oil. I should also mention that after 4 sessions with IPL, my lipiview numbers were also very low although my doctor performing the IPL said he saw a lot of improvement. I think doctors can be misleading and say things you want to hear but are actually not true.

[Becky]

I guess that depends on how much value you put on your health. I spent $1700 and I would have paid twice that to get my life back. It is only money. I had the Lipiflow 2 weeks ago and already see improvement every day and my eys are really bad. Eventually the Insurance will cover this as it is better then cataract surgery and Insurance pays that. I had both and no improvement after cataract surgery as it wasn't the cataracts causing the problems I was having.Becky