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Correction of trichiasis; incision of lid margin

CPT4 code

Name of the Procedure:

Correction of Trichiasis; Incision of Lid Margin
Commonly known as: Lid margin incision for trichiasis

Summary

The procedure involves surgically correcting trichiasis, a condition where eyelashes grow inward toward the eye, by making an incision along the eyelid margin to remove or reposition the misdirected lashes.

Purpose

Addresses: Trichiasis, which can cause irritation, discomfort, and damage to the cornea. Goals: To alleviate symptoms, prevent corneal damage, and improve ocular health by removing or redirecting the inward-growing lashes.

Indications

  • Persistent eye irritation and discomfort from inward-growing eyelashes.
  • Frequent corneal abrasion or risk of vision impairment.
  • Failed response to non-surgical treatments like epilation or lubricating eye drops.

Preparation

  • Pre-procedure Instructions: Follow specific fasting guidelines if sedation is used, typically avoid eating or drinking 6-8 hours before the procedure.
  • Medication Adjustments: Consult with the doctor about any blood thinners or medications that might need adjustment.
  • Diagnostic Tests: Complete a thorough eye examination, possibly including eyelid and corneal assessments.

Procedure Description

  1. Anesthesia: Local anesthesia is administered to numb the affected eyelid area.
  2. Incision: A precise incision is made along the eyelid margin.
  3. Correction: Misdirected lashes are either removed or redirected through the incision.
  4. Closure: The incision is closed with fine sutures if necessary.

Tools: Surgical blades, fine forceps, sutures.

Duration

Approximately 30 minutes to 1 hour, depending on the extent of the correction needed.

Setting

Typically performed in an outpatient clinic or a minor procedure room within a hospital or surgical center.

Personnel

  • Surgeon: Ophthalmologist or oculoplastic surgeon.
  • Support Staff: Surgical nurse, possibly an anesthesiologist or nurse anesthetist.

Risks and Complications

  • Common Risks: Infection, bleeding, localized swelling or bruising.
  • Rare Risks: Scarring, asymmetrical eyelid appearance, recurrence of trichiasis, reaction to anesthesia.

Benefits

  • Immediate relief from irritation and discomfort.
  • Prevention of further corneal damage.
  • Improved overall eye health and potentially better vision.

Recovery

  • Post-procedure Care: Use prescribed antibiotic or anti-inflammatory eye drops, clean and protect the surgical area.
  • Recovery Time: Usually, within a week; avoid strenuous activities that might strain the eye.
  • Restrictions: Follow any specific activity limitations advised by the healthcare provider, such as avoiding water exposure to the eye.
  • Follow-up: Scheduled check-up to monitor healing and effectiveness of the procedure.

Alternatives

  • Non-Surgical: Regular epilation (removal of eyelashes), lubricating eye drops, or eyelash growth inhibitors.
  • Pros and Cons: Non-surgical options are less invasive but may be temporary and require frequent repetition.

Patient Experience

During Procedure: Minimal discomfort due to local anesthesia; the patient may feel slight pressure.
After Procedure: Mild pain or discomfort managed with over-the-counter pain relief; temporary blurred vision or eyelid swelling is common.
Pain Management: Prescribed medications and cold compresses can help alleviate pain and swelling.

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