This is a question one of our staff asked me for a friend.
Accutane is a very concerning drug. I have now seen over 200 patients who have had serious dry eye issues who used Accutane in the past. This is still, though, a small sample size. My best friend used Accutane for years and has no symptoms, though I have never seen her meibography.
Likely Lipiflow before Accutane is not a bad idea, but I would NEVER recommend Accutane for any reason. I would recommend a gluten-free, no sugar, low inflammatory diet before even considering drugs for acne.
Still Lipiflow would not hurt.
SLC