Construction of intermarginal adhesions, median tarsorrhaphy, or canthorrhaphy
CPT4 code
Name of the Procedure:
Construction of Intermarginal Adhesions, Median Tarsorrhaphy, or Canthorrhaphy
Summary
This procedure involves partially or completely sewing the eyelids together to protect the eye. It is done for various reasons, including protection from dryness or trauma, and to support healing after surgery or injury.
Purpose
The goals include providing better eye protection, reducing exposure and drying of the eye, supporting healing after surgeries or trauma, and sometimes to relieve pain.
Indications
- Severe dry eye syndrome
- Lagophthalmos (incomplete eyelid closure)
- Corneal ulcers or other surface diseases
- Post-surgical protection and healing
- Neurological conditions affecting eyelid function
Preparation
- Patients may need to discontinue certain medications as advised by their doctor.
- Fasting may be required if general anesthesia is used.
- Diagnostic tests may include eye exams and imaging studies.
Procedure Description
- The patient is prepped, and local or general anesthesia is administered.
- The eyelids are cleaned and possibly numbed with a local anesthetic.
- The surgeon will create small incisions at the edges of the eyelids.
- The margins of the eyelids are then sewn together, forming a partial or complete tarsorrhaphy.
- The procedure usually involves delicate sutures and sometimes fine instruments like forceps and needles.
- After suturing, the area is cleaned and covered with a protective dressing.
Duration
The procedure typically takes about 30 to 60 minutes.
Setting
This procedure is usually performed in a hospital or surgical center.
Personnel
- Ophthalmic surgeon
- Surgical nurse
- Anesthesiologist (if general anesthesia is used)
Risks and Complications
- Infection
- Bleeding
- Scarring
- Asymmetry of the eyelids
- Corneal abrasion or injury
- Allergic reaction to anesthesia
Benefits
- Improved eye protection and reduced dryness
- Enhanced healing of ocular surface conditions
- Potential pain relief from corneal exposure
- Improvement in vision-related quality of life
Recovery
- Mild discomfort or swelling is expected; pain medication and cold compresses may be advised.
- Patients should avoid rubbing their eyes.
- Follow-up appointments will be scheduled to monitor healing.
- Sutures may be removed after a few weeks, depending on healing.
Alternatives
- Lubricating eye drops and ointments
- Moisture goggles
- Punctal plugs to retain tears
- Use of therapeutic contact lenses
- Each alternative has different benefits and limitations compared to surgical intervention.
Patient Experience
- Patients may feel pressure or discomfort during the procedure.
- Post-surgery, patients might experience mild pain and swelling, managed with prescribed medications.
- Vision may be temporarily reduced depending on the extent of eyelid closure.
- Adherence to post-operative care instructions is crucial for optimal results and comfort.