67316 Strabismus surgery, recession or resection procedure; 2 or more vertical muscles (excluding superior oblique)

Name of the Procedure:

Strabismus Surgery: Recession or Resection of Two or More Vertical Muscles (Excluding Superior Oblique)

Summary

Strabismus surgery is a type of eye surgery aimed at correcting the alignment of the eyes by adjusting the muscles controlling eye movement. The procedure involves either weakening (recession) or strengthening (resection) specific vertical eye muscles to improve coordination and focus.

Purpose

Strabismus surgery addresses misalignment of the eyes, a condition where the eyes do not line up properly, causing issues with depth perception and double vision. The goal is to enhance the alignment and coordination of the eyes, thereby improving visual functionality and appearance.

Indications

Indications for this procedure include:

• Diagnosed strabismus with significant misalignment.
• Persistent double vision.
• Amblyopia (lazy eye) secondary to strabismus.
• Unsuccessful non-surgical treatments like glasses or eye exercises.
• Cosmetic concerns due to eye misalignment.

Preparation

Patients are typically instructed to:

• Fast for 6-8 hours before the procedure.
• Adjust or cease certain medications as advised by the physician.
• Undergo an eye examination and possibly imaging studies.

Procedure Description

1. The patient is given general anesthesia to ensure they are asleep and pain-free.
2. The surgeon makes a small incision in the conjunctiva (the membrane covering the white part 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 to shorten it, then reattached to its original position.
5. The incisions are closed, and antibiotic ointment is applied to prevent infection.
6. A sterile pad may be placed over the eye.

Duration

The procedure typically takes 1 to 2 hours.

Setting

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

Personnel

• Ophthalmologist or pediatric ophthalmologist specializing in strabismus surgery
• Anesthesiologist
• Surgical nurses and technicians

Risks and Complications

Common risks include:

• Soreness and redness in the eyes.
• Temporary double vision.
• Overcorrection or under-correction requiring further surgery. Rare complications include:
• Infection.
• Excessive bleeding.
• Scarring.
• Anesthesia-related complications.

Benefits

The expected benefits include improved eye alignment and coordination, better visual function, reduced double vision, and enhanced appearance. Benefits can be seen within days to weeks after the procedure.

Recovery

Post-procedure care includes:

• Applying prescribed eye drops or ointments.
• Wearing an eye patch as directed.
• Avoiding strenuous activities for about a week.
• Attending follow-up appointments for monitoring healing. Recovery time ranges from a few days to a few weeks, with most patients resuming normal activities within a week.

Alternatives

• Prisms in glasses to correct double vision.
• Botulinum toxin injections to adjust muscle balance temporarily.
• Orthoptic exercises to improve muscle coordination. Each alternative varies in effectiveness and duration of results.

Patient Experience

During the procedure, patients will be under general anesthesia and will not feel pain. Post-surgery, some discomfort, and eye soreness are common but manageable with recommended pain relievers and following post-care instructions.