Repair of blepharoptosis; frontalis muscle technique with autologous fascial sling (includes obtaining fascia)
CPT4 code
Name of the Procedure:
Repair of Blepharoptosis; Frontalis Muscle Technique with Autologous Fascial Sling
Summary
This surgical procedure corrects drooping of the upper eyelid (blepharoptosis) by using a strip of the patient's own tissue (fascia) to connect the eyelid to the forehead muscle (frontalis), enabling the eyelid to lift correctly.
Purpose
The procedure is designed to correct drooping upper eyelids that can obstruct vision, improve the field of vision, and enhance the appearance of the eyes. The expected outcome is a more symmetrical and lifted upper eyelid.
Indications
- Drooping upper eyelid (ptosis) severe enough to impair vision.
- Congenital ptosis (present from birth).
- Ptosis due to muscle weakness, nerve damage, or other reasons.
- Patients who are in good overall health and can tolerate surgery.
Preparation
- Fasting for a certain period before surgery, typically 6-8 hours.
- Adjusting or stopping certain medications as advised by the surgeon.
- Preoperative blood tests and eye examinations.
Procedure Description
- Anesthesia: The patient is given local anesthesia with sedation or general anesthesia.
- Fascia Harvesting: A small incision is made, often near the thigh, to obtain a strip of fascia (connective tissue).
- Eyelid Incision: An incision is made in the upper eyelid.
- Frontalis Muscle Technique: The fascia strip is threaded through the eyelid and attached to the frontalis muscle of the forehead.
- Suturing: The fascia and incisions are sutured to hold the structures in place and allow for proper eyelid movement.
- Closure: The incisions are closed with fine sutures.
Duration
The procedure typically takes around 1 to 2 hours.
Setting
The repair is usually performed in a hospital or surgical center equipped with the necessary facilities and staff.
Personnel
- Ophthalmic surgeon or plastic surgeon specialized in oculoplastic surgery.
- Surgical nurses.
- Anesthesiologist.
Risks and Complications
- Infection.
- Bleeding.
- Scarring.
- Asymmetry of the eyelids.
- Recurrence of ptosis.
- Eye dryness or irritation.
Benefits
- Improved field of vision.
- Enhanced cosmetic appearance of the eyelids.
- Increased patient confidence and quality of life.
- Results are often noticeable shortly after recovery.
Recovery
- Apply prescribed ointments or eye drops.
- Keep the head elevated and apply cold compresses to reduce swelling.
- Avoid strenuous activities and protect the eyes from injury.
- Follow-up appointments to monitor healing.
- Most patients recover within 4-6 weeks, but minor swelling may persist longer.
Alternatives
- Non-surgical options like eyelid crutches (devices attached to glasses).
- Other surgical techniques for ptosis repair without using fascia.
- Each option varies in invasiveness, recovery time, and longevity of results.
Patient Experience
Patients may experience mild discomfort or pain, managed with medication. Postoperative swelling and bruising around the eyes are common but generally subside within a few weeks. Patients should follow all postoperative care instructions to ensure smooth recovery and optimal results.