Lipiflow versus Intense Pulsed Light (IPL) Treatments

Both Intense Pulsed Light and Lipiflow treatments have to be shown to treat Meibomian gland dysfunction but what is the difference?

Lipiflow works by inserting a scleral shell into the eye that sits behind the lids heating the glands and massaging them to push the blockage out of the glands. The treatment is performed once and is supposed to provide treatment for one year. Each treatment requires a new scleral shell and unfortunately the cost of these and the machine is very high. Most clinics charge around £1200 per treatment. Unfortunately if the treatment is not effective the first time then a second treatment is a very expensive option.

Intense Pulsed Light treatment fires a very intense light onto the skin below the eye. The frequency of the light is tuned to the Meibomian glands and has several effects. Firstly when the light is absorbed it generates heat which melts the meibum in the glands. It also closes off blood vessels close to the skin which decreases the inflammatory markers at the glands which contribute to Meibomian gland dysfunction. IPL treatment also decreases the bacterial load on the skin. Once the treatment has been performed the glands are then expressed manually – rather than mechanically as in Lipiflow. The benefit of this is that we can see exactly what comes out of the glands – whether it is solid or liquid and also to see which glands are working and which are not. The treatment is repeated several times over 3 months to give a maximal effect and each time the glands are manually expressed and examined as well. IPL treatment costs £200-£250 for each treatment.

While Lipiflow has been shown to help treat Dry Eye, at the Dry Eye Centre we believe that IPL combined with manual expression achieves better results for clients at significantly less cost. Therefore, we generally recommend IPL for clients suffering from Dry Eye over Lipiflow.

Interested in an initial assessment to see if IPL or other treatments would be right for you? Book an appointment with us today.

The different types of Dry Eye

In 2007, a groundbreaking study found that Dry Eye Disease should be classified into two different types: Aqueous tear deficiency (ATD) and evaporative dry eye (EDE).

Aqueous deficient dry eye is when there is a lack of production of the watery layer of the tears. This can be caused by an auto-immune disorder called Sjogrens, or by other causes for example as a consequence of LASER surgery. Treatments from aqueous deficient dry eye include punctal plugs and ciclosporin medication, which the Dry Eye Centre is one of the few clinics licensed to prescribe.

Evaporative dry eye is caused when the tears evaporate too quickly. This is due to factors such as a lack of the oily layer of the tears (meibum) or from incomplete blinking. Intense Pulsed Light treatment is aimed at treating evaporative dry eye.

While research has shown that a majority people suffer from evaporative dry eye, research also shows that up to 1/3 of patients suffer from combined ATD and EDE(2)  and that there are commonalities of both types, with inflammation being the most obvious.

When doing an assessment, it is vital that the professional keep an open mind and deliver a treatment program tailored to an individual's specific needs.

We believe that it takes a lot of experience and expertise to properly assess and treat patients who suffer from Dry Eye. The Dry Eye Centre was one of the first Dry Eye Speciality practices to open in the UK and our clinicians Dr. Caroline Hodd and Conan Tam are recognised experts in the field, having attended and spoken at many Eye Conferences on the subject.

If you're interested in having your own assessment done with our experts, book an appointment with us today.


Photo Credit: (1) The Definition and Classification of Dry Eye Disease: Report of the Definition and Classification Subcommittee of the International Dry Eye Work Shop (2007, THE OCULAR SURFACE / APRIL 2007, VOL. 5, NO. 2
(2) Lemp MA, Crews LA, Bron AJ, et al. Distribution of Aqueous-Deficient and Evaporative Dry Eye in a Clinic-Based Patient Cohort: A Retrospective Study. Cornea. 2012 May;31(5):472-8.