1. Q. Do I need to have Lipiflow®?
Your doctor or surgeon will usually recommend Lipiflow if there are signs of meibomian gland atrophy on meibography and/or Dry Eye Syndrome/Disease.
There are only 3 ways to save meibomian glands:
(1) Warm/hot lid compresses with massaging, blinking exercises, frequent blinking; increased Omega 3 intake.
(2) LIPIFLOW: it is a 12 minute procedure without pain. It is FDA approved to save meibomian glands.
(3) Meibomian Gland Probing with Expression with or without insertion of Autologous Serum, Platelet Rich Plasma, or Autologous (your own) Stem Cells and/or Intense Pulse Light with Expression may be needed. These procedures usually need to be repeated which can cost a great deal of money. These procedures are very uncomfortable and can be painful. They do help relieve pain in the majority of patients, but they are not FDA approved and are experimental. There have been a series of studies showing Meibomian Gland Probing and Expression help with eye pain from dry eye and revive meibomian glands, but the improvement is not 100% nor does it occur for 100% of patients.
Choosing to have Lipiflow before you loose more meibomian gland function makes sense.
2a. What is Dry eye?
Dry eye is a medical condition with health and lifestyle consequences if left untreated. In some patients, severe dry eye can cause severe chronic, debilitating pain. There are two primary forms of Dry Eye – Evaporative (which is associated with deficiency in the oily layer of your tears which comes from the Meibomian Glands) and Aqueous Deficient (which is associated with deficiency in the watery layer of tears; this occurs in patients with Sjogren’s syndrome and other autoimmune diseases.)
LipiFlow® addresses Evaporative Dry Eye, which is the most common cause of dry eye symptoms. As part of our Dry Eye Evaluation, the doctor will use several tests to assess and identify the root cause of your Dry Eye symptoms and recommend the best treatment for you.
2b. Q. What are meibomian glands?
Meibomian glands are the oil producing glands of your eye lids. If these glands do not produce enough oil or become blocked, it may contribute to your symptoms of dry eye.
3. Q. What is LipiView®?
LipiView® is a new assessment technology that allows the doctor to evaluate the structure of your meiboiman glands or lipid (oil) layer on your eyes. This assessment is part of the process to identify the root cause of your Dry Eye. The doctor’s recommendation for treatment will be based on a full evaluation of the cause of your Dry Eye Condition.
4. Q. What is LipiFlow®?
LipiFlow® is a cutting edge treatment for Evaporative Dry Eye. LipiFlow® is a thermal eyelid massage that applies consistent, comfortable heat to your eyelids. It also provides gentle, pulsating pressure to your eyelids to massage out the liquefied blockages of your meibomian glands. It attempts to milk out the oil from the glands which stimulate the glands to produce more oil in most glands.
5. Q. What happens during the LipiFlow® procedure?
The LipiFlow® Activator (disposable) is inserted under your lower and upper eye lid. It is shaped to prevent contact with the cornea, or front surface of your eye. Once in place, you simply recline in the treatment chair for the procedure.
6. Q. How long is the LipiFlow® procedure?
The LipiFlow® procedure lasts 12 minutes.
7. Q. Does LipiFlow® work?
In a clinical study, 79% of patients reported improved overall dry eye symptoms (ranging from 10% to 100% improvement) within four weeks of a single LipiFlow® treatment. Results may vary depending on factors that your doctor will discuss with you during your Dry Eye Evaluation before pursuing treatment. Referenced Clinical Study Article: Lane SS, et al. A new system, the LipiFlow, for the treatment of meibomian gland dysfunction. Cornea. 2012;31 (4):396-404.
8. Q. Is LipiFlow® FDA approved?
Yes, LipiFlow® is FDA approved. Visit: http://www.fda.gov/MedicalDevices/ProductsandMedicalProcedures/DeviceApprovalsandClearances/510kClearances/ ucm285523.htm
9. Q. What are the risks of the LipiFlow® procedure?
The only risk of Lipiflow is related to the extra oil that begins to pump out of the gland. If the orifice gets clogged, an early stye can start to form. I have never seen a patient get a stye that had to be excised because we tell patients to continue to do warm compresses after the LipiFlow® daily, particularly if you feel a sensitive spot or ball forming in the lid. Sometimes 10-100 warm compress applications per day applied over a gland are needed to prevent a full blown stye even if no LipiFlow® has been performed. Some patients need a antibiotic/steroid ointment to help open the orifice if a stye starts to develop, which is very rare. I have never seen a corneal abrasion or any other complication.
10. Q. How long do the benefits of the LipiFlow® treatment last?
The results of the LipiFlow® treatment vary person to person. It may take several weeks to feel the full effect of symptom relief. A study at Harvard showed LipiFlow’s effect can last up to 3 years if a patient continues to do daily warm/hot compresses with lid massaging for 15 minutes twice per day. The issue is that most patients do not have time, thus LipiFlow® is usually recommended once per year.
11. Q. Is LipiFlow® the only treatment option for my Dry Eye?
There are many treatment options that your doctor will discuss with you. LipiFlow® is just one of the options. After the Dry Eye Evaluation, your doctor will recommend to you the treatment options that he or she feels will best help to relieve your Dry Eye symptoms.
12. Q. Do I qualify for LipiFlow®?
Patients who have a loss of meibomian glands should consider LipiFlow®. If there are no glands left on meibography, LipiFlow® WILL NOT HELP. If there are few left, LipiFlow® will help maintain what you have but may not relieve the eye pain. Intense Pulse Light with Expression or Meibomian Gland Probing with Expression may be needed to help relieve eye pain.
13. Q. Does the Visionary Eye Doctors have LipiFlow®?
Yes, we are excited to offer the LipiFlow® technology as well as Intense Pulse Light with Video Expression or Meibomian Gland Probing with Video Expression
14. Q. How do I schedule a visit to get LipiFlow®?
Please email Allie at ABlankenship@voeyedr.com
15. Q. Will my insurance cover LipiFlow®?
At this time, the LipiFlow® procedure is not covered by most insurance plans.
16. Q. Will my insurance cover the Dry Eye Evaluation?
We can attempt to bill your medical insurance for the cost of the Dry Eye Evaluation. However, it is not guaranteed that it will be covered by your insurance.
17. Q. How many follow up visits do I need?
The number of follow up visits you will need depends on your eye’s response to treatment and your overall satisfaction.
18. Q. How much does LipiView®, LipiFlow®, and a Dry Eye Evaluation cost?
When LipiFlow® first came out at Harvard, it cost about $2000 per treatment for both eyes. The cost now ranges from about $800-$1500 depending on location.