67334 Strabismus surgery by posterior fixation suture technique, with or without muscle recession (List separately in addition to code for primary procedure)

Name of the Procedure:

Strabismus surgery by posterior fixation suture technique, with or without muscle recession
Common Names: Eye muscle surgery, Strabismus correction, Adjustable suture strabismus surgery

Summary

Strabismus surgery by posterior fixation suture technique is a surgical procedure used to correct misalignment of the eyes. This technique helps realign the eyes by adjusting the eye muscles to improve focus and coordination. The surgery can be performed with or without additional muscle recession, where a muscle is repositioned to weaken its pull.

Purpose

The procedure addresses the medical condition of strabismus, characterized by misaligned eyes that do not properly coordinate. The goal is to improve binocular vision, allowing both eyes to work together, enhance the appearance of the eyes, and relieve any associated symptoms such as double vision or eye strain.

Indications

• Constant or intermittent eye misalignment
• Diplopia (double vision)
• Eye strain or discomfort due to strabismus
• Previous unsuccessful non-surgical treatments (e.g., glasses, prisms, or eye exercises)
• Adaptation difficulties leading to vision problems

Preparation

• The patient may be required to fast for several hours before the surgery.
• An eye examination and measurements of the misalignment are necessary.
• A pre-operative evaluation including health history and possibly blood tests.
• Discuss any medications with the doctor as some may need to be adjusted or stopped.

Procedure Description

1. Anesthesia: The patient is typically under general anesthesia.
2. Eye Exposure: An eyelid speculum is used to keep the eye open.
3. Muscle Identification: The surgeon identifies the eye muscles needing adjustment.
4. Suture Placement: Posterior fixation sutures are placed to partially immobilize a muscle, thus altering its effective length and strength.
5. Optional Recession: If needed, the eye muscle is repositioned to reduce its pull.
6. Adjustment: Sutures may be adjusted during or after the surgery for optimal alignment.
7. Closure: The conjunctiva covering the white of the eye is closed.

Tools and Equipment: Scalpels, forceps, sutures, needles, eyelid speculum

Duration

The procedure typically takes about 1 to 2 hours, depending on the complexity and the number of muscles involved.

Setting

The procedure is performed in a hospital operating room or an outpatient surgical center.

Personnel

• Ophthalmologist or pediatric ophthalmologist specialized in strabismus surgery
• Anesthesiologist
• Surgical nurses and assistants

Risks and Complications

• Infection
• Bleeding
• Overcorrection or undercorrection of the eye alignment
• Double vision
• Vision loss (rare)
• Reaction to anesthesia
• Need for additional surgeries

Benefits

• Improved eye alignment and appearance
• Enhanced binocular vision and depth perception
• Reduction or elimination of double vision
• Relief from eye strain and discomfort
• Results can be noticed immediately but full benefits may take several weeks

Recovery

• The patient may experience mild pain or discomfort, managed with medications.
• Use of prescribed eye drops to prevent infection and inflammation.
• Avoid strenuous activities for a few weeks.
• Follow-up appointments to monitor healing and adjust sutures if necessary.
• Full recovery typically occurs within a few weeks to a few months.

Alternatives

• Glasses or contact lenses with prism correction
• Vision therapy (eye exercises)
• Botox injections to temporarily weaken certain eye muscles
• Each alternative has its pros and cons, such as temporary relief versus permanent correction from surgery.

Patient Experience

• During the procedure, the patient will be sedated and asleep.
• Post-surgery, there may be redness, swelling, and discomfort in the eyes.
• Vision may be blurry initially, but this usually improves as healing progresses.
• Pain management includes prescribed pain relief medication and ensuring adequate rest.

This description provides a comprehensive overview of the Strabismus surgery by posterior fixation suture technique, aiding in understanding what to expect before, during, and after the procedure.