Repair of entropion; extensive (eg, tarsal strip or capsulopalpebral fascia repairs operation)
CPT4 code
Name of the Procedure:
Repair of entropion; extensive (e.g., tarsal strip or capsulopalpebral fascia repairs operation)
Summary
This surgical procedure corrects entropion, a condition where the eyelid turns inward, causing the eyelashes to rub against the cornea. The repair can involve techniques such as tarsal strip or capsulopalpebral fascia repairs to reposition the eyelid correctly.
Purpose
The procedure addresses entropion, preventing discomfort and potential damage to the eye. The primary goal is to restore the natural position of the eyelid, alleviating symptoms like irritation, redness, and tearing, and protecting the cornea from further damage.
Indications
- Inward-turning eyelid (entropion)
- Persistent eye irritation and redness due to eyelashes rubbing against the cornea
- Tearing and discomfort that interferes with daily activities
- Risk of corneal ulceration or infection
Preparation
- Patient may need to fast for a certain period before the procedure.
- Medication adjustments might be necessary, especially if taking blood thinners.
- Diagnostic tests such as a thorough eye examination and imaging might be required.
Procedure Description
- The patient is given local anesthesia with sedatives or general anesthesia, based on the case.
- The surgeon makes a small incision on the affected eyelid.
- Techniques like tarsal strip or capsulopalpebral fascia repairs are employed to reshape and reposition the eyelid.
- The surgeon may remove or tighten some muscles and tissues to ensure the eyelid stays in the correct position.
- The incision is closed with fine sutures, and the area is dressed.
Duration
The procedure typically takes about 1 to 2 hours, depending on the complexity.
Setting
The procedure is usually performed in a hospital or surgical center, often on an outpatient basis.
Personnel
- Ophthalmic surgeon
- Anesthesiologist
- Surgical nurses
- Support staff
Risks and Complications
- Infection
- Bleeding
- Scarring
- Temporary or permanent changes in eyelid position
- Recurrence of entropion
- Adverse reactions to anesthesia
Benefits
- Relief from discomfort, irritation, and tearing
- Protection of the cornea from damage
- Improved vision and quality of life
- Results are often noticeable shortly after recovery
Recovery
- Post-operative care includes keeping the area clean and applying prescribed ointments or drops.
- Avoid rubbing the eyes and follow specific care instructions.
- Most patients can resume normal activities within a week, with full recovery in a few weeks.
- Follow-up appointments will be necessary to monitor healing.
Alternatives
- Conservative management with lubricating eye drops and ointments
- Temporary eyelid taping or suturing
- Botulinum toxin injections
- Each alternative has its pros and cons, such as temporary relief vs. permanent correction with surgery.
Patient Experience
Patients may experience mild discomfort and swelling around the surgical area. Pain management includes prescribed medications and cold compresses. Visual improvement and relief from irritation are typically immediate post-recovery.