SPOTLIGHT ON TECHNOLOGY & TECHNIQUE

Lipiflow gives doctors a real solution to evaporative dry eye

While compresses and patches attempt to clear glands through the lid, this device targets blockages.

By Bill Kekevian, Senior Associate Editor

Kerry Hagen, MD, specializes in cornea and refractive surgery at Eyehealth Northwest in Portland, Ore. Lately, he has seen patients with a cornea issue that does not require surgery. “I’ve definitely seen an increase in patients who have dry eye symptoms,” he says. “That’s a function of the age in which we live. People using computers and smartphones are suppressing their normal blinks unconsciously.”

Patients report only the slight awareness of pressure during the 12-minute treatment.

Until recently, patients had few choices to combat the discomfort associated with evaporative dry eye symptoms. Using the LipiView/LipiFlow system (TearScience, Morrisville, N.C., www.tearscience.com), Dr. Hagen says he has been able to address their needs directly.

EVAPORATIVE DRY EYE

Evaporative dry eye, characterized by meibomian gland dysfunction, is just one type of dry eye. According to a 2012 study, 86% of patients who had dry eye symptoms also had meibomian gland dysfunction.¹

In the past, Dr. Hagen says, lid scrubs, medicated pads, and warm compresses were employed, but they proved inadequate for most patients.

TESTING FOR DRY EYE

The LipiFlow system puts this treatment in the doctor’s hands. The first step is identifying patients with meibomian gland dysfunction. TearScience offers three methods; the written SPEED questionnaire, the Meibomian Gland Evaluator and the LipiView Interferometery test.

The SPEED questionnaire addresses common dry eye symptoms, grading frequency and severity, Dr. Hagen says.

The Meibomian Gland Evaluator is a handheld instrument used to evaluate gland secretions during examination.

LipiView uses imaging technology to measure the thickness of the tear film lipid layer. “During that test, the dry eye counselor will have a chance to educate the patient about the disorder,” Dr. Hagen says.

THE LIPIFLOW TREATMENT

Using special activators for each eye, the Lipiflow treatment applies heat from inside the lid, near the meibomian gland, and gentle, targeted pressure from outside the lid. The idea is to liquefy and remove meibomian blockages.

“I like to set the activators and take them out,” Dr. Hagen says. “A technician sits with the patient during the treatment.”

Lipiflow has “allowed me to offer a more definitive treatment to patients who otherwise may have been languishing with the treatment that we used to prescribe,” Dr. Hagen says. OM

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