65285 Repair of laceration; cornea and/or sclera, perforating, with reposition or resection of uveal tissue

Name of the Procedure:

Repair of laceration; cornea and/or sclera, perforating, with reposition or resection of uveal tissue

Summary

This procedure involves the surgical repair of a deep cut (laceration) in the cornea and/or sclera of the eye, which has perforated these layers and possibly displaced the uveal tissue. The surgeon will either reposition or remove the uveal tissue to restore the eye’s structure and function.

Purpose

This procedure addresses serious eye injuries involving deep lacerations that have penetrated the cornea and/or sclera. The aims are to restore the integrity of the eye, prevent further damage, and preserve or improve vision.

Indications

• Severe eye trauma with visible laceration through the cornea and/or sclera.
• Displacement or extrusion of uveal tissue.
• Symptoms like sudden vision loss, severe eye pain, or high intraocular pressure.
• Clinical findings of perforation and tissue damage upon examination.

Preparation

• Patients may need to fast for a specific number of hours before the procedure.
• Medications might need adjustment, especially blood thinners.
• Preoperative assessments including eye exams and imaging studies may be necessary to determine the extent of the injury.

Procedure Description

1. Anesthesia: The patient is given local or general anesthesia, depending on the severity of the injury and patient factors.
2. Initial Examination: A detailed examination is conducted to confirm the extent of the injury.
3. Cleaning and Draping: The eye area is cleaned and sterile drapes are placed.
4. Incision and Repair: Using microsurgical instruments, the surgeon carefully repairs the laceration. If the uveal tissue is displaced, it is repositioned or removed as needed.
5. Closure: The wound is closed with fine sutures.
6. Protective Measures: Protective eye shields or dressings are applied.

Duration

The procedure typically takes 1 to 2 hours, depending on the extent of the injury.

Setting

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

Personnel

• Ophthalmic surgeon
• Surgical nurses
• Anesthesiologist

Risks and Complications

• Infection
• Bleeding
• Scarring leading to vision impairment
• Retinal detachment
• Glaucoma (increased intraocular pressure)
• Need for additional surgeries

Benefits

Successful repair aims to restore the eye’s structural integrity and function, potentially preserving or improving vision. Benefits are often realized within weeks as the eye heals.

Recovery

• Post-procedure, patients must use prescribed eye drops to prevent infection and inflammation.
• Avoid strenuous activities and protect the operated eye.
• Regular follow-up appointments to monitor healing and vision.
• Full recovery may take several weeks to a few months.

Alternatives

• Conservative management with observation (only in less severe cases).
• Secondary surgical interventions depending on the complexity of the injury.
• Each alternative should be discussed with an ophthalmic surgeon to weigh the pros and cons.

Patient Experience

• Patients may experience mild discomfort or pain, manageable with prescribed analgesics.
• Visual disturbances are common initially but typically improve as the eye heals.
• Patients should adhere to all post-operative care instructions for optimal recovery.