65140 Insertion of ocular implant secondary; after enucleation, muscles attached to implant

Name of the Procedure:

Insertion of Ocular Implant Secondary to Enucleation

Summary

This procedure involves placing an ocular implant into the eye socket following the surgical removal of the eye (enucleation). The eye muscles are attached to the implant to allow for natural eye movement.

Purpose

The procedure addresses the absence of an eye due to trauma, infection, or diseases such as cancer. The goal is to improve the cosmetic appearance and support the fit and movement of a future prosthetic eye.

Indications

• Eye conditions that necessitate enucleation, such as severe trauma or eye cancer.
• Infections or diseases causing irreparable damage to the eye.
• Severe, untreatable pain in a blind eye.
• Cosmetic improvement after eye removal.

Preparation

• Fasting may be required for a certain period before the surgery.
• Medication adjustments may be necessary, especially for blood thinners.
• Preoperative evaluations might include blood tests, imaging studies, and a thorough medical history review.

Procedure Description

1. The patient is administered general anesthesia.
2. The surgeon makes an incision in the conjunctiva and Tenon's capsule.
3. The already enucleated eye's muscles are identified and tagged.
4. The implant is inserted into the eye socket.
5. The eye muscles are attached to the implant to allow for movement.
6. The conjunctiva is closed over the implant.
7. A pressure dressing may be applied to minimize swelling.

Duration

The procedure typically takes about 1 to 2 hours.

Setting

The procedure is performed in a hospital operating room or specialized surgical center.

Personnel

• Ophthalmic surgeon
• Anesthesiologist
• Operating room nurses
• Surgical technician

Risks and Complications

• Infection
• Implant exposure or extrusion
• Bleeding
• Swelling and discomfort
• Adverse reactions to anesthesia

Benefits

• Improved cosmetic appearance
• Facilitates better fitting and movement of a future prosthetic eye
• Potential psychological benefits from restored facial symmetry

Recovery

• Post-procedure care includes antibiotic and anti-inflammatory medication.
• The patient may be instructed to keep the head elevated to reduce swelling.
• Follow-up appointments are typically required to monitor healing.
• Full recovery generally takes several weeks.
• Physical restrictions may be advised, such as avoiding strenuous activities.

Alternatives

• No treatment, leaving the eye socket as is, which may result in cosmetic dissatisfaction.
• Various types of dermal fillers as a temporary or less invasive option.
• Custom-made prosthetic eyes without muscle attachment, which might result in less natural movement.

Patient Experience

• During the procedure, the patient will be under general anesthesia and should not feel any pain.
• After the procedure, discomfort and swelling are expected, which can be managed with prescribed medications.
• Detailed care instructions will be provided to ensure proper healing and minimize complications.