67917 Repair of ectropion; extensive (eg, tarsal strip operations)

Name of the Procedure:

Repair of Ectropion; extensive (e.g., tarsal strip operations)

Summary

This procedure is a surgical method to correct ectropion, where the eyelid turns outward, pulling away from the eye. The surgery typically involves tightening the muscles and tendons of the eyelid to restore proper alignment and function.

Purpose

The primary purpose of this procedure is to correct ectropion, a condition that can lead to eye irritation, dryness, excessive tearing, and potential damage to the cornea. The goal is to restore normal eyelid position and function, thereby protecting the eye and improving symptoms.

Indications

• Persistent irritation and redness of the eye.
• Chronic tearing (epiphora).
• Difficulty closing the eye.
• Recurrent eye infections.
• Prevention of corneal damage.
• Patients who have unsuccessful outcomes with non-surgical treatments.

Preparation

• Fasting may be required if general anesthesia is used.
• Adjustments to medications, especially blood thinners, might be necessary.
• Pre-operative assessments, including a detailed examination of the eye and eyelid, photographic documentation, and sometimes blood tests.

Procedure Description

1. Administration of local or general anesthesia.
2. An incision is made near the outer corner of the eyelid.
3. The surgeon shortens and tightens tendons and muscles, often using a tarsal strip technique.
4. Excess skin may be trimmed as necessary.
5. The wound is closed with sutures, and sometimes a temporary tarsorrhaphy (partially sewn eyelids) may be performed to aid healing.
6. A protective dressing is applied.

Duration

The procedure typically takes about 1-2 hours.

Setting

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

Personnel

• Ophthalmic or plastic surgeon
• Anesthesiologist or nurse anesthetist
• Surgical nurses and assistants

Risks and Complications

• Infection
• Bleeding
• Scarring
• Recurrence of ectropion
• Over-correction resulting in entropion (eyelid turning inward)
• Vision changes (rare)
• Adverse reactions to anesthesia

Benefits

• Improved eyelid function and appearance.
• Relief from symptoms such as dryness, irritation, and excessive tearing.
• Reduced risk of corneal damage.

Recovery

• Apply prescribed ointments and eye drops to prevent infection and inflammation.
• Use cold compresses to reduce swelling.
• Avoid strenuous activities and protect the eye from trauma.
• Follow-up appointments to monitor healing.
• The recovery period is typically 1-2 weeks, but complete healing may take a few months.

Alternatives

• Lubricating eye drops and ointments.
• Artificial tears.
• Temporary sutures or tape to hold the eyelid in place.
• Botulinum toxin injections (Botox).
• Each alternative has varying degrees of success and may be more suited to less severe cases.

Patient Experience

Patients might feel mild discomfort or tightness around the eye area during recovery. Pain is usually manageable with prescribed medications. Swelling, bruising, and temporary blurred vision can occur but gradually improve. Comfort measures include avoiding bright lights and applying cool compresses.