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
- Anesthesia: Local anesthesia is administered to numb the affected eyelid area.
- Incision: A precise incision is made along the eyelid margin.
- Correction: Misdirected lashes are either removed or redirected through the incision.
- 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.