Strabismus surgery, any procedure, superior oblique muscle
CPT4 code
Name of the Procedure:
Strabismus Surgery: Superior Oblique Muscle Surgery (also known as Superior Oblique Tendon Surgery)
Summary
Strabismus surgery involving the superior oblique muscle is a procedure aimed at correcting misalignment of the eyes due to an overactive or underactive superior oblique muscle. This muscle helps control the upward, downward, and torsional movements of the eye.
Purpose
The surgery is performed to correct strabismus (misaligned eyes), which can cause double vision, impaired depth perception, and aesthetic concerns. The goal is to align the eyes properly, improving vision coordination and appearance.
Indications
- Double vision (diplopia)
- Head tilt or turn to compensate for misalignment
- Difficulty with depth perception
- Eye misalignment not correctable with glasses or prisms
- Significant difference in vision between the two eyes
Preparation
- Fasting for 6-8 hours before the procedure
- Temporary discontinuation of certain medications (e.g., blood thinners)
- Pre-operative assessment including eye exams, and imaging if necessary
Procedure Description
- The patient is given general anesthesia.
- An incision is made in the conjunctiva (the membrane that covers the white of the eye).
- The superior oblique muscle or tendon is located.
- Depending on the specific issue, the muscle might be shortened (resection), lengthened (recession), or sometimes an adjustable suture technique is used.
- The incision is closed with sutures.
- Eye is covered with a patch post-procedure if needed.
Duration
The procedure typically takes about 1 to 1.5 hours.
Setting
The surgery is performed in a hospital or specialized surgical center.
Personnel
- Ophthalmic surgeon
- Anesthesiologist
- Surgical nurses
Risks and Complications
- Infection
- Bleeding
- Over-correction or under-correction requiring further surgery
- Double vision (diplopia) post-surgery
- Scarring
- Brief vision loss
- Anesthesia-related complications
Benefits
- Improved eye alignment
- Better depth perception
- Relief from double vision
- Enhanced cosmetic appearance
- Overall improved quality of life
Recovery
- Use of eye patches or protective glasses
- Prescription eye ointments or drops to prevent infection
- Avoiding strenuous activities for several weeks
- Follow-up appointments to monitor healing
- Possible temporary use of prism glasses
Alternatives
- Prism glasses for small misalignments
- Vision therapy
- Botox injections to temporarily relax the muscles
- Observation in less severe cases
Patient Experience
Patients may experience some discomfort and swelling post-surgery. Pain management typically includes over-the-counter pain medications. Initial redness, tearing, and sensitivity to light are common and usually subside within a few days to weeks. Full recovery can take several weeks, during which time patients need to follow specific instructions regarding activity and eye care.