68320 Conjunctivoplasty; with conjunctival graft or extensive rearrangement

Name of the Procedure:

Conjunctivoplasty; with conjunctival graft or extensive rearrangement

Summary

Conjunctivoplasty is a surgical procedure designed to repair and reconstruct the conjunctiva—the thin, transparent tissue covering the white part of the eye and the inside of the eyelids. This can involve grafting tissue from another part of the conjunctiva or rearranging existing tissue extensively to restore normal structure and function.

Purpose

The procedure addresses conjunctival damage or changes, such as scarring, tumors, pterygium, or other growths. The goal is to restore the conjunctiva's normal appearance and function, alleviating symptoms and preventing further issues.

Indications

• Conjunctival diseases or pterygium causing discomfort, redness, or vision problems
• Scarring or damage due to trauma, infection, or chemical burns
• Tumors or abnormal growths on the conjunctiva
• Chronic inflammation not responding to medical treatment Suitable candidates include patients with the above conditions who have not responded to less invasive treatments.

Preparation

• Fasting for at least 8 hours before the procedure, if general anesthesia is used
• Stopping certain medications, such as blood thinners, under a doctor's guidance
• Pre-procedure evaluation including a detailed eye examination and possibly imaging studies

Procedure Description

1. The patient is given anesthesia (local or general) for comfort.
2. The surgeon carefully assesses and marks the area of the conjunctiva to be repaired.
3. Diseased or damaged tissue is removed.
4. A graft from the healthy conjunctiva or another suitable tissue, often from the same eye or the other eye, is prepared.
5. The graft is then sutured into place or the existing tissue is rearranged to cover the defect.
6. Antibiotic and anti-inflammatory drops are applied to prevent infection and control swelling.

Duration

The procedure typically takes 1-2 hours, depending on the extent of the repair needed.

Setting

Performed in a hospital operating room or an outpatient surgical center.

Personnel

• Ophthalmic surgeon
• Surgical nurses
• Anesthesiologist (if general anesthesia is used)
• Surgical assistants

Risks and Complications

• Infection
• Bleeding
• Graft failure or rejection
• Scarring
• Persistent redness or discomfort
• Visual disturbances, though rare Complications are managed through medication, additional surgical intervention, or tailored follow-up care.

Benefits

• Restoration of normal conjunctival function and appearance
• Relief from symptoms such as redness, irritation, and discomfort
• Prevention of further ocular complications
• Immediate benefits often seen post-recovery

Recovery

• Use of prescribed antibiotic and anti-inflammatory eye drops
• Avoiding strenuous activities and eye rubbing for several weeks
• Follow-up appointments to monitor healing
• Recovery period is typically 2-4 weeks, with most patients returning to normal activities within a month

Alternatives

• Medical management with eye drops or ointments
• Less invasive procedures such as simple excision (if applicable)
• Observation if symptoms are mild and not impacting quality of life Each alternative has its own pros and cons, often requiring a tailored discussion with an eye specialist.

Patient Experience

The patient might experience mild discomfort, which is managed with pain relievers. Some redness and swelling can occur initially. Post-procedure instructions focus on ensuring comfort and promoting healing to allow a swift return to normal activities.