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Strabismus surgery, recession or resection procedure; 1 horizontal muscle

CPT4 code

Name of the Procedure:

Strabismus Surgery, Recession or Resection Procedure; 1 Horizontal Muscle

Summary

Strabismus surgery involves adjusting the muscles around the eye to correct misalignment. The two main techniques are recession (loosening the muscle) and resection (tightening the muscle), specifically targeting one horizontal muscle.

Purpose

Strabismus surgery addresses eye misalignment, where one or both eyes turn inward, outward, upward, or downward. The main goal is to improve eye alignment and function, potentially enhancing vision and improving cosmetic appearance.

Indications

Patients experiencing eye misalignment, double vision, or significant eye strain may be candidates for this procedure. It is also indicated in cases of lazy eye (amblyopia) if non-surgical treatments are ineffective.

Preparation

Patients are typically advised to avoid eating or drinking after midnight before the surgery. Medications may need adjustment, particularly blood thinners. Pre-operative assessments often include a comprehensive eye exam and possibly imaging tests.

Procedure Description

  1. The patient is given general anesthesia.
  2. An incision is made in the conjunctiva (the outer membrane of the eye).
  3. For recession: The muscle is detached from its original insertion and reattached further back on the eye.
  4. For resection: A section of the muscle is removed, and the shortened muscle is reattached to its original position.
  5. The incision is closed with dissolvable stitches.

Tools include scalpels, forceps, and sutures.

Duration

The procedure typically takes about 30 to 90 minutes.

Setting

The surgery is usually performed in a hospital or an outpatient surgical center.

Personnel

The procedure involves an ophthalmologist specializing in strabismus surgery, surgical nurses, and an anesthesiologist.

Risks and Complications

Common risks include infection, bleeding, and swelling. Rare complications can involve further misalignment, vision loss, or need for additional surgery.

Benefits

Patients can expect improved eye alignment, which may enhance both function and appearance. Benefits are often realized shortly after recovery.

Recovery

Post-procedure, patients may need to use eye drops and wear an eye patch. Full recovery typically takes a few weeks, with restrictions on heavy lifting and rigorous activities. Follow-up appointments are crucial to monitor healing and eye alignment.

Alternatives

Non-surgical options include glasses with prisms, vision therapy, or Botox injections. Each alternative has different effectiveness and duration of benefits compared to surgery.

Patient Experience

Patients may experience mild to moderate discomfort post-surgery, which can be managed with medications. They may also notice temporary double vision or blurred vision as the eye heals and adjusts.

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