hey what's up? Dr. Allen here, today we are reviewing lipiflow treatment the in office dry eye
treatment specifically for dry eye syndrome and meibomian gland dysfunction and one of the major
reasons we are talking about lipiflow here today is because it is one of the most commonly found
and offered dry eye treatments through your local eye doctor's office and in this review we're going
to cover things like what is it how does lipiflow work and then answering common questions that both
my patients and viewers often ask such as what is the cost is lipiflow covered by insurance and
when is lipiflow worth it because believe it or not there are times
when i do not recommend lipiflow for my patients and this will all come from both my objective and
subjective experience both as a patient of the procedure as well as a doctor performing it for
my patients in the clinic and i love covering topics like this so hit that like button for me
if you enjoy these sort of honest and in-depth reviews so the lipiflow treatment was specifically
designed to treat the most common form of dry eye disease known as evaporative dry eye
that means once again we're going to be talking about meibomian gland dysfunction also known as
mgd we all start with about 60 meibomian glands on each eye and whether it be due to hormones diet
environmental factors skin conditions and lifestyle factors like computer use
these glands can eventually get clogged up become inflamed and even potentially die off
and if you're either not making enough oils or the oils you're making are very poor quality then your
tear film ends up evaporating very quickly which leads to an increase in salt content
and loss of homeostasis and balance of your tear film historically treatment for meibomian gland
dysfunction has always included doing things like warm compresses and this is something that many
people do at home but the heat is supposed to act to melt the thickened oils within those eyelids
and then that allows the oils to run smooth and allow for decreased evaporation of that tear film
at least fundamentally that's how lipiflow works except it's been specifically designed
to heat the temperature of the eyelids to the precise temperature of where the oils begin to
melt in those oil glands and then lipiflow has a pumping mechanism which will squeeze both eyelids
from both directions and that helps express the oils within the oil glands doing a full meibomian
gland expression that way the old thickened meibum or oils that are trapped in those glands
get melted and then they get expressed from those meibomian glands allowing for new oils to be made
and released upon each blink and many studies have shown that lipiflow can not only decrease
the inflammatory load on the surface of the eye but increase your TBUT or tear breakup
time essentially decreasing the evaporation as well as improve your OSDI scores which stands for
ocular surface disease index scores so again at heart the whole goal of lipiflow is to heat those
thickened oils get them to express so that your eyelids are able to make new oils to prevent your
tears from evaporating therefore improving your dry eye symptoms and preventing meibomian gland
dysfunction from eventually causing death of those oil glands to the point where you can't get them
restored so it's as much of a dry eye treatment to improve your symptoms as it is a preventative
measure to prevent those oil glands from dying off in contrast to things like warm compresses
although warm compresses can help people with really mild dry eye symptoms the clinical benefit
of warm compresses is minimal at best and they are pretty time consuming and to be fully honest
most people just don't do them or they just don't do them on a regular basis let me know
in the comment section if you've ever tried worm compresses and if you actually do them you see
lipiflow is kind of like having 180 warm compress treatments done all at one time i got that number
because at least one published study found pretty similar results of a single lipiflow treatment
to doing about warm compresses twice a day every day for three months except that because of the
way lipiflow works it may in fact be safer as well as more efficient at treating meibomian
gland dysfunction and dry eye than using warm compresses now the whole experience of having
lipiflow done is honestly pretty comfortable and is sort of like having a full spa treatment for
your dry eyes and a huge thank you and shout out to our student doctor Monica who volunteered to
sit as our patient for this video demonstration assuming that your doctor has already determined
that you are a good candidate for the lipiflow procedure the first step is that your doctor
will put some numbing eye drops into the eyes just to make the eyes more comfortable
then the lipiflow device comes with these little eye devices they're almost like little eye cups
these are then inserted behind the eyelids both top and bottom and this cup provides a both a
safety mechanism to protect the cornea as well as provide direct heat to the inner sides of both
eyelids and this is really important because not only does it provide heat directly to the eyelids
but it prevents the eyeball from getting heated up and prevents any excess pressure from being
pushed onto the eye as too much pressure on the cornea from a warm compress can not only warp
the cornea temporarily but may potentially be an issue for people who have glaucoma or a condition
called keratoconus i'm not aware of any studies specifically looking into worm compresses and
the effect on those conditions but i know in our profession there is some concern over that
and at least with lipiflow we know that that's not really a concern but the whole lipiflow procedure
only lasts about 12 minutes that includes both the heating of the eyelids to the precise temperature
of the melting of the glands as well as the meibomian gland expression that occurs
and really after that you're all done unless your doctor chooses to evaluate you the oil glands
behind the slit lamp afterward just to manually express any oil glands that maybe need just a
little bit more expression now as far as lipiflow cost typically the prices i've seen for lipiflow
go from anywhere from the 700 us dollar range up to about the 1500 us dollar range but that'll
largely depend on the location as well as the cost of running the procedure at your doctor's office
they say that because when you have this procedure done the individual eye cups they actually cost
money to run those cups individually so when your doctor purchases the lipiflow device not
only do they have to buy the instrument itself but then they have to buy those individual eye cups
every single time that you run the procedure because the eye cups have been programmed to
only use once and then they self-terminate which really falls into a whole other topic
of frustration i have with modern medicine but we'll save that for another video but as the
price of these individual lipiflow heads goes down then so will the overall price for this procedure
now some of you may be asking is lipiflow covered by insurance and the answer is yes and no
technically there is a procedural code for it however most insurances do not accept it and it
also depends on the location of which you live so for most people it is going to be cash pay
so is lipiflow worth it for most people i would say yes in fact i would say for most
of the people that come into the clinic i wish i could just run this on just about everyone and
the reason i say that is because it has a great preventative utility and we just know that with
everyone's lifestyles being on the computer these days most people would benefit from having it
done at least once and studies do show that even just after one treatment it can have long-lasting
effects up to one to three plus years with most people who have dry eye syndrome benefiting from
at least one procedure done a year and some people with bad meibomian gland dysfunction
needing it probably more often but there are times when i don't recommend having lipiflow done that
is either one somebody comes in and they don't have any problems with meibomian gland dysfunction
which is pretty rare or two they have such extreme forms of meibomian gland dysfunction that in fact
they don't have any meibomian glands left they've completely atrophied because at that point if
you don't have any glands left there's really no point to having the procedure done now because of
the success of lippy flow there are several other companies that are coming out with similar designs
such as the ilux for example which we've actually covered on this channel if you want to check out
that video of the ilux device i'll put a youtube card link up appear up above as well as in the
video description below so you can check that out if you want but at least one published study which
i'll try to put a link to below as well that did compare lipiflow vs ilux and found the results to
be very comparable and speaking from at least my experience having it done as well as the feedback
i get from my patients when you have the procedure done it's very comfortable again doesn't hurt at
all and almost everybody i've ever done it on reports that their eyes do feel better afterward
the first day or two things may be a little bit more gritty and rough and at least the reason
i think that is is because you remove all these oils from your glands and these oils have a lot
of inflammatory proteins in them and so you kind of get this rebound inflammation on the surface
as well as you're not you're not your glands don't have much oils in them anymore afterward
so when you're blinking the first few days you're maybe not getting as much oil on them
but i know after three four plus days beyond that most of my patients including myself noticed
dramatic improvements in our symptoms but be sure to let me know in the comments what your thoughts
are on lipiflow have you had it done yourself and would it be something that you would consider
getting either way thanks for watching keep an eye on it and we'll talk to you soon you