Name of the Procedure:

Repair of Laceration; Cornea and/or Sclera, Perforating, Not Involving Uveal Tissue

Summary

This procedure involves the surgical repair of a perforating laceration in the cornea and/or sclera (the white part of the eye), without affecting the uveal tissue (the middle layer of the eye that includes the iris). The goal is to restore the integrity of the eye's outer layers after an injury has caused a full-thickness tear.

Purpose

The procedure addresses injuries to the eye that have resulted in full-thickness tears of the cornea or sclera. The primary goal is to close the laceration, preventing further damage and potential complications such as infection or loss of vision. It aims to restore the eye’s structural integrity and preserve visual function.

Indications

• Full-thickness "through-and-through" lacerations of the cornea or sclera.
• Traumatic injuries leading to clear perforations that do not involve the uveal tissue.
• Symptoms such as visible tears, disruption in the eye's continuity, pain, decreased vision, or leaking fluid from the eye.

Preparation

• Fasting for a specified period before the procedure.
• Temporary discontinuation of certain medications as advised by the surgeon.
• Pre-procedure eye examinations and imaging tests to assess the extent of the injury.

Procedure Description

1. Anesthesia: The patient receives local or general anesthesia depending on the severity and location of the laceration.
2. The area around the eye is cleaned and sanitized.
3. Using fine surgical instruments, the surgeon carefully aligns the edges of the laceration.
4. Sutures (stitches) are placed to close the tear in a manner that supports healing and restores structural integrity.
5. The surgeon checks for proper closure and makes any necessary adjustments.
6. The eye may be covered with a protective shield or patch post-surgery.

Duration

Typically, the procedure takes between 1 to 2 hours, depending on the complexity of the laceration.

Setting

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

Personnel

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

Risks and Complications

• Infection at the surgical site
• Incomplete healing or reopening of the laceration
• Scarring that could affect vision
• Increased intraocular pressure
• Corneal or retinal detachment in severe cases

Benefits

• Restores the structural integrity of the eye.
• Prevents further damage and potential vision loss.
• Allows for the proper healing of the injured area.
• Reduction in pain and discomfort following injury repair.

Recovery

• Post-procedure care includes the use of antibiotic eye drops to prevent infection.
• Anti-inflammatory medications to reduce swelling and pain.
• Follow-up appointments to monitor healing and suture removal if necessary.
• Patients can expect some discomfort and blurry vision immediately following the procedure, which generally improves within a week.
• Full recovery can take several weeks, during which strenuous activities and eye rubbing should be avoided.

Alternatives

• Observation and non-surgical management in very minor cases.
• Medication to manage symptoms if the injury is not severe.
• Laser treatments for specific types of eye injuries but this is less common for perforating lacerations.
• Each alternative comes with its own set of pros and cons, including varying levels of effectiveness and potential complications.

Patient Experience

During the procedure, patients under local anesthesia may feel pressure or mild discomfort but should not feel pain. Under general anesthesia, they will be asleep throughout the procedure. Post-operatively, patients may experience mild to moderate discomfort, managed with prescribed pain relief medications. Vision may be blurred initially but is expected to improve gradually as healing proceeds.