{"id":5534,"date":"2026-09-09T13:40:01","date_gmt":"2026-09-09T13:40:01","guid":{"rendered":"https:\/\/smartdryeyes.com\/?page_id=5534"},"modified":"2026-09-09T17:03:58","modified_gmt":"2026-09-09T17:03:58","slug":"tixel-treatment-for-dry-eyes","status":"publish","type":"page","link":"https:\/\/smartdryeyes.com\/en\/tixel-treatment-for-dry-eyes\/","title":{"rendered":"Tixel Treatment for Dry Eyes"},"content":{"rendered":"\n<div class=\"wp-block-group alignfull sde-tx is-layout-flow wp-block-group-is-layout-flow\">\n\n<div class=\"txhero\">\n<div class=\"txw\">\n<div class=\"txhero-in\">\n<div>\n<p class=\"eyebrow\">Treatment<\/p>\n<h1>Tixel Treatment for Dry Eyes<\/h1>\n<p class=\"txlede\">Two minutes of precisely limited heat, conducted through the eyelid skin to the glands behind it. Tixel uses no light at all, which is why it works the same way on every skin tone and at every time of year.<\/p>\n<div class=\"txbtns\"><a class=\"txp\" href=\"https:\/\/smartdryeyes.com\/en\/get-access\/\">Start your screening<\/a><a class=\"txo\" href=\"https:\/\/smartdryeyes.com\/en\/dry-eye-treatment-options\/\">All treatment options<\/a><\/div>\n<\/div>\n<figure><img src=\"https:\/\/smartdryeyes.com\/wp-content\/uploads\/2026\/04\/dr-hanneken-tixel-1.png\" alt=\"Dr. Ludger Hanneken performing a Tixel treatment on a patient's eyelids\" fetchpriority=\"high\" decoding=\"async\"><\/figure>\n<\/div>\n<dl class=\"txglance\"><div><dt>Duration<\/dt><dd>2 \u2013 5 minutes<\/dd><\/div><div><dt>Sessions<\/dt><dd>3, two weeks apart<\/dd><\/div><div><dt>Comfort<\/dt><dd>Brief hot pulses, well tolerated<\/dd><\/div><div><dt>Downtime<\/dt><dd>None; mild warmth for a few hours<\/dd><\/div><\/dl>\n<\/div>\n<\/div>\n\n\n\n<div class=\"txnav\">\n<div class=\"txw\">\n<ul><li><a href=\"#what-tixel-treats-in-dry-eye-disease\">What Tixel treats in dry eye disease<\/a><\/li><li><a href=\"#how-tixel-works-on-the-meibomian-glands\">How Tixel works on the meibomian glands<\/a><\/li><li><a href=\"#the-device\">The device<\/a><\/li><li><a href=\"#what-a-tixel-session-is-like\">What a Tixel session is like<\/a><\/li><li><a href=\"#what-the-evidence-shows-for-tixel\">What the evidence shows for Tixel<\/a><\/li><li><a href=\"#who-tixel-suits-and-who-it-does-not\">Who Tixel suits, and who it does not<\/a><\/li><li><a href=\"#what-it-costs\">What it costs<\/a><\/li><li><a href=\"#tixel-questions\">Tixel questions<\/a><\/li><\/ul>\n<\/div>\n<\/div>\n\n\n\n<div class=\"txb\">\n<div class=\"txw\">\n<div class=\"txsplit\"><div><div class=\"txhead\"><span class=\"txnum\">01<\/span><span class=\"txrule\"><\/span><\/div><h2 class=\"txh\" id=\"what-tixel-treats-in-dry-eye-disease\">What Tixel treats in dry eye disease<\/h2><\/div><div><div class=\"txprose\"><p>Tixel is used for evaporative dry eye, the form driven by meibomian gland dysfunction. The meibomian glands sit in vertical rows inside the upper and lower lids and release the oil that seals the tear film. When that oil thickens it stops leaving the gland, the tear film loses its lid, and the water underneath evaporates within seconds of a blink. That is the burning, gritty, worse-by-evening feeling most patients arrive with.<\/p><p>The treatment addresses the thickened oil itself rather than the symptoms it causes. Because it is a heat treatment and not a light treatment, skin colour, a recent tan and the season are all irrelevant to it.<\/p><\/div><\/div><\/div>\n<\/div>\n<\/div>\n\n\n\n<div class=\"txb txb--tint\">\n<div class=\"txw\">\n<div class=\"txsplit\"><div><div class=\"txhead\"><span class=\"txnum\">02<\/span><span class=\"txrule\"><\/span><\/div><h2 class=\"txh\" id=\"how-tixel-works-on-the-meibomian-glands\">How Tixel works on the meibomian glands<\/h2><figure class=\"txchain\"><figcaption>Mechanism<\/figcaption><ol><li><span class=\"n\">01<\/span><span class=\"t\">Titanium tip at 385 \u2013 405 \u00b0C<\/span><\/li><li><span class=\"n\">02<\/span><span class=\"t\">Contact of six thousandths of a second<\/span><\/li><li><span class=\"n\">03<\/span><span class=\"t\">Heat conducted into the lid skin<\/span><\/li><li><span class=\"n\">04<\/span><span class=\"t\">The tarsal plate warms<\/span><\/li><li><span class=\"n\">05<\/span><span class=\"t\">Waxy meibum softens and flows<\/span><\/li><\/ol><\/figure><\/div><div><div class=\"txprose txprose--blocks\"><div class=\"txlede-b\"><h3>Conducted heat, not light<\/h3><p>The handpiece carries a small titanium tip set with 24 blunt pyramids. The tip is held between 385 and 405 \u00b0C and touches the eyelid skin for about six thousandths of a second at a time. In that instant heat passes into the skin by direct conduction, the way a warm hand warms a cold one.<\/p><p>Nothing is emitted: no laser, no light, no radiofrequency. Each pyramid holds only a fixed, very small amount of energy, so the peak heat the eyelid can receive is capped by physics rather than by the steadiness of the operator&#8217;s hand.<\/p><\/div><div class=\"txlede-b\"><h3>What the warmth does to the meibum<\/h3><p>Ten pulses are placed along each lid. The warmth reaches the tarsal plate, where the glands lie, and softens meibum that has turned waxy. In a healthy eye meibum melts a little below the surface temperature of the lid, so it flows out with every blink.<\/p><p>In meibomian gland disease its composition shifts and its melting point rises above the temperature the lid naturally reaches, so it stiffens and stays where it is. Restoring that temperature difference is what allows the gland to empty again. A rigid shield sits under the lids throughout, so the eye itself is never exposed to the tip.<\/p><\/div><\/div><div class=\"txcall\"><p>Tixel is the one treatment in the Smart Dry Eyes programme that is tied to a single technology. Everything else on this site is described independently of any manufacturer.<\/p><\/div><\/div><\/div>\n<\/div>\n<\/div>\n\n\n\n<div class=\"txb\">\n<div class=\"txw\">\n<div class=\"txhead\"><span class=\"txnum\">03<\/span><span class=\"txrule\"><\/span><\/div><h2 class=\"txh\" id=\"the-device\">The device<\/h2>\n<p class=\"txdevnote\">Smart Dry Eyes is not tied to any manufacturer. The systems below are the ones most often used for this treatment in our partner centres and in European practice generally. Which one a centre runs does not change the treatment you receive.<\/p>\n<div class=\"txdevs txdevs--1\">\n<div class=\"txdev\"><div class=\"txdev-img\"><img src=\"https:\/\/smartdryeyes.com\/wp-content\/uploads\/2026\/09\/sde-tixel-i.webp\" alt=\"Tixel i \u2014 Novoxel, Israel\" loading=\"lazy\" decoding=\"async\"><\/div><div class=\"txdev-b\"><h3>Tixel i<\/h3><p class=\"maker\">Novoxel, Israel<\/p><p class=\"d\">The ophthalmic model. Cleared by the US FDA in November 2024 for evaporative dry eye caused by meibomian gland dysfunction, reviewed in the same regulatory class as thermal pulsation devices rather than as a light device.<\/p><p class=\"txcredit\">Image: Novoxel Ltd. \u00b7 tixelmed.com<\/p><\/div><\/div>\n<\/div>\n<p class=\"txcreditnote\">Device photographs are the property of their respective manufacturers and are reproduced here to identify the equipment described. Smart Dry Eyes has no commercial relationship with these manufacturers.<\/p>\n<\/div>\n<\/div>\n\n\n\n<div class=\"txb txb--tint\">\n<div class=\"txw\">\n<div class=\"txhead\"><span class=\"txnum\">04<\/span><span class=\"txrule\"><\/span><\/div><h2 class=\"txh\" id=\"what-a-tixel-session-is-like\">What a Tixel session is like<\/h2>\n<ol class=\"txsteps\"><li><h3>Before<\/h3><p>A drop of anaesthetic is placed on the eye and a rigid shield is slid under the lids. Numbing ointment on the skin is available but most patients do not need it.<\/p><\/li><li><h3>During<\/h3><p>Ten pulses along each of the four lids. Each pulse feels like a short, sharp warmth. The whole treatment takes under two minutes.<\/p><\/li><li><h3>After<\/h3><p>The shield comes out and you leave. You can drive, work and read straight away. Mild warmth or pink skin along the lid can last a few hours.<\/p><\/li><li><h3>The course<\/h3><p>Three sessions two weeks apart. The improvement builds across the course rather than arriving after the first visit.<\/p><\/li><\/ol>\n<\/div>\n<\/div>\n\n\n\n<div class=\"txb\">\n<div class=\"txw\">\n<div class=\"txsplit\"><div><div class=\"txhead\"><span class=\"txnum\">05<\/span><span class=\"txrule\"><\/span><\/div><h2 class=\"txh\" id=\"what-the-evidence-shows-for-tixel\">What the evidence shows for Tixel<\/h2><\/div><div><div class=\"txev\"><div class=\"txevr\"><p class=\"k\">Randomised, five centres, 106 patients<\/p><div class=\"v\"><p>The strongest study to date is a randomised, evaluator-masked trial across five centres in which 106 patients received either Tixel or LipiFlow, the established thermal pulsation treatment (Sadri and colleagues, Journal of Cataract &#038; Refractive Surgery, 2025). Tear break-up time improved by roughly three seconds in both groups at four and at twelve weeks, and Tixel met the statistical threshold for non-inferiority. Symptom scores improved somewhat more in the Tixel group. Patients also reported the Tixel pulses as briefly less comfortable than LipiFlow.<\/p><\/div><\/div><div class=\"txevr txevr--pos\"><p class=\"k\">What the smaller studies do and do not show<\/p><div class=\"v\"><p>Two earlier studies were smaller and had no control group (Safir and colleagues, 2022; Shah and colleagues, 2023). They support the finding rather than establish it. All three were funded or co-authored by people connected to the manufacturer, and no sham-controlled trial of Tixel in dry eye has been published. Non-inferiority to LipiFlow means Tixel is not worse than an accepted treatment; it does not mean it is better than one.<\/p><\/div><\/div><\/div><div class=\"txdisc\"><p>Dr. Ludger Hanneken, medical director of the Smart Dry Eyes network, is a co-author of Shah and colleagues (2023) and is disclosed in that paper as an advisor to Novoxel.<\/p><\/div><\/div><\/div>\n<\/div>\n<\/div>\n\n\n\n<div class=\"txb txb--tint\">\n<div class=\"txw\">\n<div class=\"txhead\"><span class=\"txnum\">06<\/span><span class=\"txrule\"><\/span><\/div><h2 class=\"txh\" id=\"who-tixel-suits-and-who-it-does-not\">Who Tixel suits, and who it does not<\/h2>\n<div class=\"txtwo\"><div class=\"txcard txcard--yes\"><h3>Usually a good fit<\/h3><ul><li>Evaporative dry eye with confirmed meibomian gland dysfunction<\/li><li>Darker or recently tanned skin, where IPL is restricted or unsafe<\/li><li>Patients who want the shortest treatment in the programme<\/li><li>Anyone treated year-round, including through the summer<\/li><\/ul><\/div><div class=\"txcard txcard--no\"><h3>Not suitable, or postponed<\/h3><ul><li>Pregnancy or breastfeeding<\/li><li>Isotretinoin taken in the past twelve months<\/li><li>Active eye infection, or herpes simplex or zoster<\/li><li>Eye surgery within the past six months, or existing punctal plugs<\/li><li>Bleeding disorders, anticoagulant treatment, or keloid scarring<\/li><li>Aqueous-deficient dry eye such as Sj\u00f6gren&#8217;s syndrome, where the glands are not the problem<\/li><\/ul><\/div><\/div>\n<\/div>\n<\/div>\n\n\n\n<div class=\"txb\">\n<div class=\"txw\">\n<div class=\"txhead\"><span class=\"txnum\">07<\/span><span class=\"txrule\"><\/span><\/div><h2 class=\"txh\" id=\"what-it-costs\">What it costs<\/h2>\n<div class=\"txprice txprice--1\">\n<div class=\"txpcard\"><p class=\"region\">Europe<\/p>\n<div class=\"txprow\"><p class=\"lbl\">Tixel, full course of three sessions<small>full course<\/small><\/p><p class=\"amt\">from \u20ac800<\/p><\/div>\n<div class=\"txprow\"><p class=\"lbl\">Follow-up visit<\/p><p class=\"amt\">from \u20ac150<\/p><\/div>\n<\/div>\n<\/div>\n<p class=\"txpfoot\">Entry prices. What you pay depends on the centre, on how many sessions your diagnosis calls for, and on whether treatments are combined. In Germany these are private-pay treatments: statutory insurers do not reimburse them, private insurers and Beihilfe often do, in part. Your centre confirms the figure before anything begins.<\/p>\n<\/div>\n<\/div>\n\n\n\n<div class=\"txb txb--tint\">\n<div class=\"txw\">\n<div class=\"txhead\"><span class=\"txnum\">08<\/span><span class=\"txrule\"><\/span><\/div><h2 class=\"txh\" id=\"tixel-questions\">Tixel questions<\/h2>\n<div class=\"txfaq\"><details><summary>Does Tixel hurt?<\/summary><div class=\"a\"><p>Each pulse is a short, distinct heat that most patients describe as sharp rather than painful, and it is over in milliseconds. In the trial that compared the two directly, patients rated Tixel as briefly less comfortable than LipiFlow. Numbing ointment is available if you would rather have it.<\/p><\/div><\/details><details><summary>How long does the effect last?<\/summary><div class=\"a\"><p>Reported benefit runs to about six months in the published follow-up. Clinics sometimes quote nine to twelve months; the trials do not go that far, so treat longer figures as claims rather than findings. Most patients return for a maintenance session once symptoms begin to creep back.<\/p><\/div><\/details><details><summary>Can I have Tixel if my skin is dark, or if I am tanned?<\/summary><div class=\"a\"><p>Yes. This is the practical difference between Tixel and IPL. IPL relies on light being absorbed by pigment, so it is restricted by skin type and by recent sun exposure. Tixel transfers heat by touch, so neither applies.<\/p><\/div><\/details><details><summary>Tixel or IPL?<\/summary><div class=\"a\"><p>They do different things. Tixel warms the glands so thickened oil can leave them. IPL works on the inflamed vessels along the lid margin that keep the glands irritated. Patients with visible redness and ocular rosacea usually benefit more from IPL; patients whose main problem is blocked, waxy glands usually benefit more from heat. The two are often used together.<\/p><\/div><\/details><\/div>\n<\/div>\n<\/div>\n\n\n\n<div class=\"txb\"><div class=\"txw\"><div class=\"txcta\"><h2>Find out which treatment your eyes actually need<\/h2><p>Every treatment on this page works on a different part of the problem. A guided screening establishes which part is yours, and your centre builds the plan from there.<\/p><div class=\"txbtns\"><a class=\"txp\" href=\"https:\/\/smartdryeyes.com\/en\/get-access\/\">Start your screening<\/a><a class=\"txo\" href=\"https:\/\/smartdryeyes.com\/en\/dry-eye-treatment-options\/\">All treatment options<\/a><\/div><\/div><\/div><\/div>\n\n\n\n<div class=\"txb txb--tint\"><div class=\"txw\"><h2 class=\"txh\">Other dry eye treatments<\/h2><div class=\"txrel\"><a class=\"txrelc\" href=\"https:\/\/smartdryeyes.com\/en\/eyelid-cleansing-blepharoexfoliation\/\"><span class=\"t\">Eyelid cleansing<\/span><span class=\"g\">Clearing biofilm and debris from the lid margin<\/span><\/a><a class=\"txrelc\" href=\"https:\/\/smartdryeyes.com\/en\/meibomian-gland-expression\/\"><span class=\"t\">Gland expression<\/span><span class=\"g\">Emptying glands the blink can no longer empty<\/span><\/a><a class=\"txrelc\" href=\"https:\/\/smartdryeyes.com\/en\/ipl-treatment-for-dry-eyes\/\"><span class=\"t\">IPL<\/span><span class=\"g\">Light on the lid margin vessels that keep glands inflamed<\/span><\/a><a class=\"txrelc\" href=\"https:\/\/smartdryeyes.com\/en\/low-level-light-therapy-for-dry-eyes\/\"><span class=\"t\">Low-level light therapy<\/span><span class=\"g\">Red and blue light to calm the lid and its glands<\/span><\/a><a class=\"txrelc txrelc--hub\" href=\"https:\/\/smartdryeyes.com\/en\/dry-eye-treatment-options\/\"><span class=\"t\">Dry eye treatment options<\/span><span class=\"g\">All seven, compared<\/span><\/a><\/div><p class=\"txrev\">Medically reviewed by Dr. Ludger Hanneken, medical director, Smart Dry Eyes.<\/p><\/div><\/div>\n\n\n\n<script type=\"application\/ld+json\">{\"@context\": \"https:\/\/schema.org\", \"@type\": \"FAQPage\", \"mainEntity\": [{\"@type\": \"Question\", \"name\": \"Does Tixel hurt?\", \"acceptedAnswer\": {\"@type\": \"Answer\", \"text\": \"Each pulse is a short, distinct heat that most patients describe as sharp rather than painful, and it is over in milliseconds. 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The two are often used together.\"}}]}<\/script>\n\n<\/div>\n","protected":false},"excerpt":{"rendered":"<p>Treatment Tixel Treatment for Dry Eyes Two minutes of precisely limited heat, conducted through the eyelid skin to the glands [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"site-sidebar-layout":"default","site-content-layout":"","ast-site-content-layout":"default","site-content-style":"default","site-sidebar-style":"default","ast-global-header-display":"","ast-banner-title-visibility":"","ast-main-header-display":"","ast-hfb-above-header-display":"","ast-hfb-below-header-display":"","ast-hfb-mobile-header-display":"","site-post-title":"disabled","ast-breadcrumbs-content":"disabled","ast-featured-img":"","footer-sml-layout":"","ast-disable-related-posts":"","theme-transparent-header-meta":"","adv-header-id-meta":"","stick-header-meta":"","header-above-stick-meta":"","header-main-stick-meta":"","header-below-stick-meta":"","astra-migrate-meta-layouts":"default","ast-page-background-enabled":"default","ast-page-background-meta":{"desktop":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"ast-content-background-meta":{"desktop":{"background-color":"var(--ast-global-color-4)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"tablet":{"background-color":"var(--ast-global-color-4)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""},"mobile":{"background-color":"var(--ast-global-color-4)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-opacity":"","overlay-gradient":""}},"footnotes":""},"class_list":["post-5534","page","type-page","status-publish","hentry"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v28.3 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Tixel Treatment for Dry Eyes | Smart Dry Eyes<\/title>\n<meta name=\"description\" content=\"Tixel warms the meibomian glands through the eyelid with heat conducted from a titanium tip. 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