Repair of entropion; suture
CPT4 code
Name of the Procedure:
Repair of Entropion; Suture
Summary
The repair of entropion using sutures is a surgical procedure aimed at correcting an eyelid that has turned inward, causing the eyelashes to irritate the eye. This condition can lead to discomfort, excessive tearing, and potential damage to the cornea. The surgery involves repositioning the eyelid to its natural orientation using sutures.
Purpose
The procedure addresses entropion, a condition where the eyelid margin turns inward. The primary goals are to relieve irritation, protect the cornea, reduce tearing, and improve the patient's overall comfort and eye health.
Indications
- Chronic eye irritation and redness
- Excessive tearing or discharge
- Sensation of a foreign body in the eye
- Visible inward turning of the eyelid
- Corneal damage or ulceration due to eyelid position
Preparation
- Patients may need to fast for several hours before the procedure.
- Adjustments to current medications, particularly blood thinners, may be necessary.
- A thorough eye examination and possibly imaging tests to assess the severity of the entropion.
Procedure Description
- The patient is positioned comfortably, and local anesthesia is administered to numb the area around the eye, sometimes accompanied by mild sedation.
- An incision is made near the affected eyelid.
- The surgeon places sutures (stitches) to reposition the eyelid so it aligns correctly.
- The sutures are tied and adjusted to ensure the eyelid stays in the desired position.
- The incision is closed, and the area is cleaned and dressed as needed.
Duration
The procedure typically takes about 30 to 60 minutes.
Setting
The entropion repair is usually performed in an outpatient clinic or a surgical center.
Personnel
- Ophthalmic surgeon
- Nurses
- Anesthesiologist (if sedation is used)
Risks and Complications
- Infection
- Bleeding
- Scarring
- Recurrence of entropion
- Changes in eyelid function or appearance
- Temporary or permanent vision changes
Benefits
- Relief from eye irritation and discomfort
- Protection of the cornea from damage
- Improved vision if previously impaired by the condition
- Enhanced quality of life and comfort
Recovery
- Patients will receive specific post-operative care instructions, including how to care for the incision site.
- Use of antibiotic ointments or eye drops as prescribed.
- Avoidance of strenuous activities and eye rubbing.
- Follow-up appointments to monitor healing.
- Most patients resume normal activities within 1 to 2 weeks, with complete recovery in about 4 to 6 weeks.
Alternatives
- Non-surgical options such as lubricating eye drops or temporary tape to reposition the eyelid.
- Botulinum toxin (Botox) injections to weaken the muscles turning the eyelid inward.
- Surgical correction using different techniques (e.g., skin excision or muscle manipulation).
Pros and Cons:
- Non-surgical options may provide temporary relief but don't offer a permanent solution.
- Botox injections can be less invasive but may need repeated treatments.
- Surgical alternatives vary in complexity and efficacy; discussing these with an ophthalmologist can help determine the best approach.
Patient Experience
- During the procedure, patients usually experience minimal discomfort due to local anesthesia.
- Post-operatively, there might be mild pain, swelling, and bruising around the eye, managed with prescribed medications.
- Most patients notice significant improvement in symptoms shortly after surgery, with full benefits realized as healing progresses.