Wednesday, January 18, 2012

Abstract: Lipiflow versus WHAT?

ARGHHH!

I want so much to see studies on Lipiflow, and here's one, but what does it do? Tells me that Lipiflow beats iHeat! You have GOT to be kidding me. Anything beats iHeat, whether it's the hated washcloth, or the hot potato or boiled eggs I hear some patients saying their doctors recommended, or just me holding my coffee cup against my eyelids... to say nothing of my beloved rice baggies or Thermoeyes or the myriad warm compresses sold commercially which, unlike iHeat, actually stand a chance of producing heat sufficient to liquefy meibum. No offense to the manufacturers but, er, when I tested it, iHeat was about as low on the warm compress totem pole as you can go.

I literally cannot conceive of a less useful warm compress treatment to compare Lipiflow efficacy to. Next please!

A New System, the LipiFlow, for the Treatment of Meibomian Gland Dysfunction (MGD).

PURPOSE:
To evaluate the safety and effectiveness of the LipiFlow System compared to the iHeat Warm Compress (WC) for adults with meibomian gland dysfunction (MGD).

METHODS:
This was a non-significant risk, prospective, open-label, randomized, crossover multicenter clinical trial. One hundred thirty-nine subjects were randomized between LipiFlow (n=69) and WC control (n=70). Subjects in the LipiFlow group received a 12-minute LipiFlow treatment and were reexamined at 1 day, 2 weeks and 4 weeks. Control subjects received a 5-minute iHeat treatment with instructions to perform the same treatment daily for 2 weeks. At 2 weeks, they crossed over (LipiFlow Crossover) and received the LipiFlow treatment. Effectiveness parameters: meibomian gland (MG) assessment, tear break-up time (TBUT) and dry eye symptoms. Safety parameters: adverse events, ocular health exam, ocular surface staining, intraocular pressure, visual acuity and discomfort.

RESULTS:
LipiFlow resulted in significant improvement (P < 0.05) in MG secretion at 2 and 4 weeks (mean ± standard deviation at baseline = 6.3 ± 3.5; 2 weeks = 14.3 ± 8.7; 4 weeks = 16.7 ± 8.7); and TBUT at 2 and 4 weeks: (at baseline = 5.5 ± 2.9; 2 weeks = 6.9 ± 5.0; 4 weeks = 7.4 ± 5.5). There was no significant change in MG secretion or TBUT in the control group. LipiFlow resulted in a greater significant reduction in dry eye symptoms than the iHeat WC. The crossover group demonstrated similar significant improvement 2 weeks post-treatment with the LipiFlow. There was no significant difference between groups in the incidence of non-serious, device-related adverse events.

CONCLUSION:
The LipiFlow System was significantly more effective than iHeat WC. These results support its safety and effectiveness in the treatment of MGD and dry eye symptoms.


Cornea. 2012 Jan 4. [Epub ahead of print]
Lane SS, 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.

1 comment:

carlos said...

I had lipiflow in Toronto and it had good response for about 6 to 8 wks, then back to clogged glands despite the use of 5 grams of fish oil, 50 mg of doxycicline and daily heat application. A study showing improvements at only 4 wks over no treatment would have been expected by me, but that does changes the dysfunction of the glands.