67901 Repair of blepharoptosis; frontalis muscle technique with suture or other material (eg, banked fascia)

Name of the Procedure:

Repair of Blepharoptosis; Frontalis Muscle Technique with Suture or Other Material (e.g., Banked Fascia)

Summary

This procedure involves repairing drooping of the upper eyelid (blepharoptosis) by connecting the eyelid to the frontalis muscle using sutures or other materials such as banked fascia. This helps the eyelid to be lifted effectively by the forehead muscle.

Purpose

Blepharoptosis is a condition where the upper eyelid droops over the eye, potentially obstructing vision. The goal of the procedure is to improve eyelid position, enhance field of vision, and improve the facial appearance.

Indications

• Significant drooping of the upper eyelid obstructing vision
• Congenital or acquired blepharoptosis
• Poor function of the levator muscle responsible for lifting the eyelid
• Cosmetic concerns due to drooping eyelid

Preparation

• Pre-operative assessment including medical and ophthalmic history
• Physical examination focusing on eyelid function and structure
• Possible imaging studies or eye tests
• Fasting for 6-8 hours prior to surgery if general anesthesia is used
• Adjusting medications, such as blood thinners, if necessary, as per doctor's advice

Procedure Description

1. Administration of local or general anesthesia.
2. A small incision is made in the upper eyelid or brow area.
3. Sutures or banked fascia are used to create a sling connecting the eyelid to the frontalis muscle.
4. The eyelid is adjusted to the desired position.
5. The incision is closed with sutures.
6. Sterile dressings are applied to the operated area.

Duration

Approximately 1-2 hours.

Setting

Typically performed in a hospital, outpatient surgical center, or specialized ophthalmology clinic.

Personnel

• Ophthalmic or plastic surgeon
• Surgical nurses
• Anesthesiologist (if general anesthesia is used)
• Operation room support staff

Risks and Complications

• Infection
• Bleeding
• Scarring
• Overcorrection or undercorrection of eyelid position
• Asymmetry between eyelids
• Temporary or permanent vision changes
• Discomfort or pain

Benefits

• Improved field of vision
• Enhanced cosmetic appearance
• Increased comfort and improved function of the eye
• Immediate improvement in eyelid position post-surgery

Recovery

• Application of cold compresses to reduce swelling
• Prescribed pain management
• Avoid vigorous activities and heavy lifting for about two weeks
• Follow-up appointments to monitor healing and remove sutures if necessary
• Recovery time typically ranges from a few days to 2 weeks

Alternatives

• Non-surgical methods such as eyelid crutches or special glasses (less effective)
• Other surgical techniques like levator resection or Muller’s muscle-conjunctival resection
• Each alternative comes with its own set of risks, benefits, and effectiveness which should be discussed with a healthcare provider

Patient Experience

Patients can expect:

• Mild pain and swelling immediately after the procedure, managed with prescribed medications.
• Possible temporary vision blurriness due to swelling.
• Instructions on cleaning and care of the surgical site.
• Most discomfort and bruising usually subsides within a week.