Let’s face it… there is nothing more frustrating than spending time, money and effort on treatments that aren’t effective.
While there is no magic bullet when it comes to treating many complex, chronic diseases like dry eye, some treatments are clearly more effective than others. I started my ophthalmology residency in 2004 (read: I’ve been around a long time) which was right after Restasis was FDA approved to treat dry eye. This was very exciting as it was the first drug ever to get FDA approval for dry eye. Unfortunately, when we started using it in clinical practice, the results were underwhelming, to say the least. Very few patients reported significant improvement and after diving into the studies conducted for FDA approval, it is clear why.
The studies showed an increase in tear production at 6 months. That’s right… It takes 6 months to see if you are going to benefit from Restasis! Basically, it got FDA approval because there was nothing else on the market that was FDA approved for dry eye at that time. Fast forward 20 years and we fortunately have much more effective medications that work much more quickly. Xiidra was shown to start working within 14 days and Vevye within 29 days, making them much better options than Restasis.
Many of my patients have tried Lipiflow before coming to see me and have been disappointed with their results. I had the Lipiflow device for a year, and while I do think it helps, the results are very temporary. According to the company, the results last a year, but that was not what I was seeing in my practice.
I decided to dive deeper into the research, and the original FDA approval for Lipiflow was in 2011, and the studies showed that Lipiflow was better than warm compresses at 2 weeks. Yep, the studies showed that the benefits last 2 weeks, not 1 year! There have since been studies done that the company likes to quote showing longer lasting results, but the problem is that those studies were poorly done with small sample sizes and no controls (which is why they weren’t included in the FDA approval).
The problem is Lipiflow is expensive because the device requires one-time use activators that are thrown away after the treatment and they are very costly, making the treatment costly. I do think there is a short term benefit to it, and if it was more cost effective, patients could do it on a regular basis but unfortunately it’s not. I think this goes for all the thermal pulsation devices on the market such as iLux and TearCare. They all work by heating and compressing the glands, which is helpful but there is no way that will provide a long term benefit.
So in the end,
I think it’s important to read the studies and know the research as it helps guide our decisions, and that is even more important now that we have so many treatment options. Choosing an ophthalmologist that stays current, knows the science and takes the time to properly diagnose and treat your issues will lead to better outcomes.
If you're experiencing bothersome eye issues, Dr. Lauren Zimski is a trusted Denver-area doctor you can depend on for customized treatment plans.
Schedule an appointment online or call 303-863-1231. First, take a few minutes to fill out our SPEED questionnaire and we’ll get in touch.