Repair of blepharoptosis; (tarso) levator resection or advancement, internal approach
CPT4 code
Name of the Procedure:
Repair of Blepharoptosis; (tarso) Levator Resection or Advancement, Internal Approach (commonly referred to as eyelid lift surgery).
Summary
Eyelid lift surgery, also known as ptosis repair, involves surgically correcting drooping upper eyelids by tightening or reattaching the levator muscle through an internal approach.
Purpose
The procedure addresses droopy upper eyelids (blepharoptosis) that can interfere with vision or eyelid function. The goal is to improve vision, eyelid appearance, and overall eye functionality.
Indications
- Impaired vision due to drooping eyelids
- Asymmetrical eyelids
- Eyelid fatigue or discomfort
- Congenital or acquired ptosis
Patient criteria include sufficient levator muscle function and generally good overall health.
Preparation
- Pre-procedure consultation to discuss medical history and goals.
- Possible fasting, if general anesthesia is used.
- Stopping certain medications as advised by the doctor.
- Conducting preoperative tests, such as vision assessments and eyelid measurements.
Procedure Description
- The patient is typically given local anesthesia with sedation or general anesthesia.
- An incision is made on the inside of the eyelid.
- The levator muscle is accessed, and either a portion is resected (cut) or the muscle is advanced (moved forward).
- The levator muscle is then secured in its new position to lift the eyelid.
- The incision is closed with sutures that are often absorbable.
Tools and technology used include surgical scalpels, sutures, and sometimes specialized lifting instruments.
Duration
The procedure typically takes 45 minutes to 1 hour per eyelid.
Setting
The surgery can be performed in an outpatient clinic, hospital, or specialized surgical center.
Personnel
The procedure involves a team that may include:
- An ophthalmic or plastic surgeon.
- Nurses to assist during surgery.
- An anesthesiologist for sedation or anesthesia.
Risks and Complications
Common risks:
- Bruising and swelling
- Temporary discomfort
- Dry eyes
Rare risks:
- Infection
- Over or under-correction of eyelid position
- Bleeding
- Vision changes
Complications are managed with medication, additional procedures, or adjustments.
Benefits
Expected benefits include improved vision, a more symmetrical and aesthetically pleasing appearance, and better eyelid function. These benefits are typically realized within a few weeks after surgery.
Recovery
- Use of ice packs and prescribed medications to manage pain and swelling.
- Avoiding strenuous activities for the first week.
- Keeping the head elevated and following strict hygiene practices to prevent infection.
- Follow-up appointments with the surgeon to monitor healing. Full recovery usually takes around 4 to 6 weeks, with most swelling and bruising subsiding within the first two weeks.
Alternatives
- Non-surgical treatments like eyelid exercises or special glasses
- External eyelid surgery options (front approach ptosis repair)
- Cons of alternatives: May be less effective or suitable for severe cases.
Patient Experience
During the procedure, patients under local anesthesia might feel pressure but not pain. Post-procedure, expect some discomfort, swelling, and bruising. Pain is typically managed with prescribed medications, and most patients return to normal activities within a week, with full results visible after complete healing.