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Lipiflow and the Research

What does Lipiflow treat?

Lipiflow is the only FDA approved treatment for Meibomian Gland Dysfunction (MGD).  This condition is responsible for most causes of dry eyes.   The Meibomian gland is found in the eyelids adjacent to the eyeball itself. It is the most common cause of Dry Eye Disease.  If left untreated it may cause scarring on the eyelids or cornea, redness, tearing, burning, itching and even permanent vision problems.   Additionally, the meibomian gland will shrink resulting in more dryness that can be permanent.  The glands will eventually be lost to shrinkage and inflammation.  The body does not have the ability to regenerate these glands, nor will the grow back.  It is best treated early, because we can not grow the glands, but may be treated anytime the diagnosis is made, even if symptoms haven't yet begun. Similar to hypertension and diabetes, damage occurs before the disease becomes symptomatic.   The treatment is geared towards opening the clogged meibomian (oil) glands.   This is done most effectively with a state of the art machine in our office during a 12 minute  painless and easy treatment. The treatment is called LipiFLow and is completely pain-free.   A small device is placed on the eyelids and safely heats the clogged oil glands while gentle pulsations expel the melted material.  The following studies from the medical literature support the effectiveness and safety of this valuable treatment.

Can hot compresses do the same as Lipiflow?


The Limitation of Applying Heat to the External Lid Surface: A Case of Recalcitrant Meibomian Gland Dysfunction.


Case Rep Ophthalmol. 2017 Jan 16;8(1):7-12. doi: 10.1159/000455087. eCollection 2017 Jan-Apr.

Kenrick CJ1, Alloo SS1
Purpose- To compare four commercially available heat therapies for recalcitrant meibomian gland dysfunction.

Conclusion- Given that the anatomic position of the meibomian glands is adjacent to the palpebral conjunctiva, and therefore closer to the inner eyelid surface than the outer surface, it is reasonable to expect that application of heat to the inner eyelid surface would be more effective in increasing the temperature of the glands.   Thus, it is not surprising that LipiFlow was the only therapy which elevated the temperature above the target value...The potential problem of heating the inner eyelid surface without raising the temperature of the cornea is achieved by the LipiFlow activators in a unidirectional heating surface that simultaneously insulates the ocular surface. 


Layman's Interpretation:  Of 4 products which apply heat to the eyelids, only LipiFlow achieves the...temperature needed to melt the material clogging the meibomian glands.  This is because LipiFlow is the only product which applies heat to the inner surface of the eyelids.  Lipiflow will achieve a temperature of 108.5 degrees.  A cornea shield will protect the cornea preventing burns.  When applying heat to the external lid it is quickly dissipated and the glands do not get the desired temperature to melt the oils.   Using a higher temperature hot compress may cause a thermal burn to the lids, cornea and glands themselves.  Lipiflow is the preferred method to treat MGD.

How long will it last? Is it safe?

   


A new system, the LipiFlow, for the treatment of meibomian gland dysfunction.

Cornea. 2012 Apr;31(4):396-404. doi: 10.1097/ICO.0b013e318239aaea.


Lane SS1, DuBiner HB, Epstein RJ, Ernest PH, Greiner JV, Hardten DR, Holland EJ, Lemp MA, McDonald JE 2nd, Silbert DI, Blackie CA, Stevens CA, Bedi R

Purpose- To evaluate the effect of a single treatment with the LipiFlow Thermal Pulsation System on signs of meibomian gland dysfunction (MGD) and dry eye symptoms over a 9-month period.

Conclusion- With such prolonged improvement in signs and symptoms of dry eye disease, the LipiFlow Thermal Pulsation System offers a technological advancement for the treatment of dry eye disease secondary to meibomian gland dysfunction. A single 12-minute LipiFlow treatment results in up to 9 months of sustained improvement of meibomian gland function, tear break-up time and dry eye symptoms that are unparalleled with current dry eye treatments.


Layman's Interpretation: LipiFlow is more effective than other heat application systems.  LipiFlow is safe.  There were no adverse effects on vision, eye pressure, or any aspect of ocular health.  In our practice, we will provide our patients an effective treatment plan that will typically make the Lipiflow treatment last 2 years.  This is something we have not ever been able to accomplish in the past and has helped most every one of our patient's

How does it compare to other treatments? Will it help my lifestyle?



Meibomian gland dysfunction: a comparative study of modern treatments

J Fr Ophtalmol. 2014 Apr;37(4):303-12. doi: 10.1016/j.jfo.2013.12.007. Epub 2014 Mar 20.



Baumann A1, Cochener B2.
Purpose- To evaluate a thermal pulsation treatment compared to a warming eyelid device for the management of meibomian gland dysfunction.
Conclusion- The combination of heat applied to the inner eyelid surface, together with simultaneous expression of the glands, during a single 12-minute treatment shows to be highly effective in treating cases of meibomian gland disease. Whilst results were excellent, and continued lid hygiene remains advised, the benefit of being able to simultaneous address potential compliance issues relating to ongoing treatment is significant. The convenience of a single 12-minute treatment versus an ongoing daily heating regime was shown to be highly desirable and a welcome relief in our patients' busy lifestyles.
Layman's Interpretation:  LipiFlow provides a faster improvement than twice daily compresses and the 12 minute treatment is more convenient than ongoing twice daily compresses for patients with busy lifestyles.  In our experience, most patient's are unable to do hot compresses effectively.  Patient's have also burned their skin.  Many whom work regular jobs can't commit to the time required to do them.  The combination of all these factors makes Lipiflow the treatment of choice.  

How do I know if I'm a candidate?

Prior to having the Lipiflow procedure, and inflammatory test will be performed.  Photographic and Infrared imaging will be taken to determine the health and gland loss you currently have.  Tear assessments will be performed by multiple modalities.  We only suggest Lipiflow to patient's that need it and will have a good outcome.  Most patients are candidates that have MGD.  

What level of success do you have?

In our experience, which is enormous, we have found that Lipiflow helps most all patients.  The exact percentage is about 98%.  Essentially, we see all of our patient's oil production significantly improve.   While the quality of the oil is almost always significantly improved, the quantity of tears may not be enough if the gland loss is too much.  In this case, we have other treatment's that will help virtually all of our patient's.  Additionally, the regimen used after Lipiflow is not the same with all doctors.  We have found our regimen to have the best outcomes.