Orbital implant (implant outside muscle cone); insertion
CPT4 code
Name of the Procedure:
Orbital Implant Insertion (implant outside muscle cone) Common name(s): Orbital Implant Surgery
Summary
This procedure involves the placement of an implant in the eye socket (orbit) but outside the group of muscles that control eye movement. It is usually done to replace the volume in the orbit, often after the removal of an eye.
Purpose
The orbital implant insertion is performed to:
- Restore the natural appearance of the eye socket.
- Prevent the sinking or collapsing of the surrounding tissues.
- Enable the attachment of a prosthetic eye to improve facial symmetry.
Indications
- Patients who have undergone enucleation (removal of the eye).
- Individuals with significant trauma or disease affecting the eye.
- Conditions such as severe eye infections, cancers, or painful blind eyes.
Preparation
- Pre-procedure assessment including a detailed eye examination and imaging studies like CT or MRI scans.
- Patients may be advised to fast for a certain period before the surgery.
- Medication adjustments will be made, especially if the patient is on blood thinners or other critical medications.
Procedure Description
- Anesthesia: General anesthesia is usually administered.
- Incision: A small incision is made in the conjunctiva (the lining of the eye socket).
- Placement: The implant is inserted into the eye socket in the space outside the muscle cone.
- Securing: The implant is secured in place, often with sutures.
Closure: The incision is closed, and an absorbable dressing may be applied.
Tools and Equipment: Surgical scissors, retractors, specialized orbital implants, suturing materials.
Duration
The procedure typically takes about 1 to 2 hours.
Setting
Performed in a hospital or a specialized surgical center.
Personnel
- Ophthalmic Surgeon or Oculoplastic Surgeon
- Anesthesiologist
- Surgical Nurses
Risks and Complications
- Common risks: Infection, bleeding, swelling, and pain.
- Rare risks: Implant displacement, rejection, or extrusion, chronic inflammation.
Benefits
- Restored cosmetic appearance and facial symmetry.
- Minimized risks of socket contraction and other complications associated with an empty orbital space.
- Improved psychological well-being and social confidence.
Recovery
- Post-procedure instructions may include antibiotic and anti-inflammatory medications.
- Cold compresses to reduce swelling and discomfort.
- Limited physical activity several days post-surgery.
- Follow-up appointments to monitor healing and implant position.
- Full recovery and adjustment to prosthetic eye usually take several weeks.
Alternatives
- Non-surgical options are limited.
- Evisceration (removal of eye contents) with implant placement inside the muscle cone.
- Traditional ocular prosthesis without an orbital implant, though less effective functionally and aesthetically.
Patient Experience
- During the procedure: Under general anesthesia, so no pain is felt.
- Post-procedure: Some discomfort and swelling which are managed with medications.
- Return to normal activities gradually as directed by the healthcare provider.
- Psychological support may be beneficial for adjusting to cosmetic changes.
This comprehensive guide should help patients understand the process and expectations for an orbital implant insertion procedure.