65270 Repair of laceration; conjunctiva, with or without nonperforating laceration sclera, direct closure

Name of the Procedure:

Repair of laceration; conjunctiva, with or without nonperforating laceration sclera, direct closure.
Common Name(s): Conjunctival and scleral laceration repair.

Summary

This procedure involves the surgical repair of a tear (laceration) in the conjunctiva, the thin layer covering the white part of the eye, and possibly the sclera, the white part itself, if the laceration does not fully penetrate.

Purpose

The procedure addresses traumatic injuries to the conjunctiva, and possibly the sclera, to restore the integrity and function of the eye tissues. The goals are to promote healing, prevent infection, and restore normal vision.

Indications

• Trauma resulting in a laceration of the conjunctiva.
• Nonperforating (not fully penetrating) laceration of the sclera.
• Symptoms can include eye pain, redness, vision disturbances, and visible cuts or tears.

Preparation

• Pre-procedure instructions may include fasting if general anesthesia is required.
• Adjustments to certain medications, particularly blood thinners.
• Diagnostic tests such as a thorough eye examination and imaging studies like ultrasound or CT scan may be performed.

Procedure Description

1. The patient will be positioned comfortably, often lying down.
2. Anesthesia will be administered; local or general anesthesia may be used depending on the injury's extent.
3. If local anesthesia is used, the area around the eye will be numbed.
4. The laceration is inspected, cleaned, and any debris is removed.
5. The surgeon uses fine sutures to close the conjunctival tear directly. For scleral involvement, the sclera is repaired first if needed.
6. Antibiotic drops or ointment may be applied to prevent infection.
7. The eye may be covered with a protective patch or dressing.

Duration

The procedure typically takes about 30 minutes to 2 hours, depending on the complexity and severity of the laceration.

Setting

This procedure is usually performed in a hospital operating room or an outpatient surgical center.

Personnel

• Ophthalmologist or ocular surgeon.
• Surgical nurses or assistants.
• Anesthesiologist if general anesthesia is used.

Risks and Complications

• Infection.
• Bleeding.
• Scarring.
• Incomplete healing of the laceration.
• Vision changes or loss.
• Anesthesia-related risks.

Benefits

• Heals the injured tissue and prevents further damage.
• Reduces the risk of infection.
• Improves or restores normal vision function.
• Relief from pain and discomfort.

Recovery

• Patients may need to use prescribed antibiotic eye drops.
• Pain management with over-the-counter or prescribed pain relievers.
• Avoid strenuous activities and protect the eye from injury.
• Follow-up appointments are necessary to monitor healing.
• Full recovery may take a few weeks to a couple of months, depending on the injury's severity.

Alternatives

• Observation and conservative management for very minor lacerations.
• Non-surgical treatments such as ointments or eye drops alone may be insufficient for most significant lacerations.
• Pros of surgical repair include faster healing and reduced complications, whereas cons include surgical risks and downtime for recovery.

Patient Experience

• During the procedure, patients under local anesthesia might feel pressure but should not feel pain.
• Post-procedure, some discomfort, and mild pain are common.
• Pain management options and eye protection measures help improve comfort during recovery.