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Strabismus surgery, recession or resection procedure; 1 vertical muscle (excluding superior oblique)

CPT4 code

Name of the Procedure:

Strabismus Surgery, Recession or Resection Procedure; 1 Vertical Muscle (excluding Superior Oblique)

Summary

Strabismus surgery is a procedure used to correct misalignment of the eyes. This particular surgery involves either weakening (recession) or strengthening (resection) one of the vertical eye muscles, excluding the superior oblique muscle.

Purpose

This surgery addresses strabismus, a condition where the eyes do not properly align with each other. The goal is to improve eye alignment for better binocular vision and appearance. It can also reduce vision problems related to strabismus, such as double vision.

Indications

  • Ocular misalignment that affects vision or causes noticeable cosmetic issues
  • Double vision or difficulty with depth perception
  • Eye strain or discomfort due to strabismus
  • Failure of non-surgical treatments like glasses or eye exercises

Preparation

  • Fasting for at least 8 hours before the procedure
  • Adjustments to medications as advised by the healthcare provider
  • Pre-operative eye examination and measurements
  • Potential blood work or imaging tests to assess overall health and eye structure

Procedure Description

  1. The patient is given local or general anesthesia depending on age and medical needs.
  2. An incision is made on the conjunctiva (the white part of the eye).
  3. For recession, the selected vertical muscle is detached from its original place and reattached further back to weaken its action.
  4. For resection, a portion of the muscle is removed, and the shortened muscle is reattached to strengthen its action.
  5. The incision is closed with sutures, and the eye is covered with a sterile bandage.

Duration

The procedure typically takes between 30 minutes to 1 hour.

Setting

Strabismus surgery is usually performed in a hospital operating room or an outpatient surgical center.

Personnel

  • Ophthalmic Surgeon
  • Anesthesiologist or Nurse Anesthetist
  • Surgical Nurses or Technicians

Risks and Complications

  • Infection
  • Bleeding
  • Overcorrection or undercorrection of eye alignment
  • Double vision
  • Scarring
  • Anesthesia-related risks

Benefits

  • Improved eye alignment
  • Enhanced binocular vision
  • Reduced double vision and eye strain
  • Better cosmetic appearance

Recovery

  • Apply prescribed eye drops or ointments
  • Avoid strenuous activities and swimming for at least 1 week
  • Use an eye shield at night to protect the eye
  • Attend follow-up appointments to monitor healing
  • Most patients can resume normal activities within a few days to a week

Alternatives

  • Prismatic glasses to correct minor misalignments
  • Botulinum toxin (Botox) injections to temporarily realign eyes
  • Orthoptic exercises (eye exercises) to strengthen eye muscles
  • Observation in less severe cases

Patient Experience

During the procedure, patients under general anesthesia will feel nothing, while those under local anesthesia may feel slight pressure but no pain. After surgery, patients may experience mild discomfort, redness, and swelling which can be managed with prescribed medications. Full recovery typically occurs within a few weeks, and noticeable improvements can be seen soon after the procedure.

Medical Policies and Guidelines for Strabismus surgery, recession or resection procedure; 1 vertical muscle (excluding superior oblique)

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