Repair of ectropion; thermocauterization

CPT4 code

Name of the Procedure:

Repair of Ectropion; Thermocauterization

Summary

Repair of ectropion using thermocauterization is a surgical procedure aimed at correcting the outward turning of the eyelid, typically the lower lid, by using heat to promote tissue tightening and healing.

Purpose

This procedure addresses ectropion, a condition where the eyelid turns outward, exposing the inner eyelid surface. The goal is to restore the normal position of the eyelid, protect the eye, and improve both function and appearance.

Indications

Chronic eye irritation or redness
Excessive tearing
Dry eyes
Recurrent eye infections or ulcers
Previous failed treatments of ectropion

Preparation

Patients may be advised to fast for several hours if general anesthesia is used.
Preoperative assessment including a detailed medical history and specific tests like a slit-lamp examination.
Discontinuation of specific medications like blood thinners as advised by the physician.

Procedure Description

Anesthesia: Local anesthesia with sedation or general anesthesia is administered.
Incision: A small incision along the lower eyelid might be made to allow access to the underlying tissues.
Thermocauterization: A special device that generates controlled heat is used to cauterize the tissues, tightening and shortening them to reposition the eyelid.
Closure: The incision is closed with fine sutures, if applicable.
Dressing: A sterile dressing may be applied to protect the site.

Duration

The procedure typically takes about 30 to 60 minutes.

Setting

This procedure is commonly performed in an outpatient surgical center or hospital.

Personnel

Ophthalmologist or oculoplastic surgeon
Surgical nurse
Anesthesiologist (if general anesthesia is used)

Risks and Complications

Infection
Bleeding or hematoma formation
Scarring
Asymmetry
Overcorrection or under-correction
Temporary or permanent changes in eyelid sensation

Benefits

Restored normal eyelid position
Reduced irritation and tearing
Improved eye protection and visual function
Enhanced cosmetic appearance Benefits are typically realized within a few weeks as the healing process completes.

Recovery

Application of antibiotic ointment and wearing of the sterile dressing as directed
Cold compresses to minimize swelling
Avoiding strenuous activities and heavy lifting
Follow-up appointments to monitor healing
Most patients recover fully in 2 to 4 weeks.

Alternatives

Non-surgical treatments (e.g., lubricating eye drops, taping of the eyelid)
Other surgical techniques such as lateral tarsal strip surgery or full-thickness skin grafting
Pros and cons of alternatives depend on the severity and underlying cause of ectropion.

Patient Experience

During the procedure, minimal discomfort due to anesthesia
Post-procedure, mild pain and swelling are common; pain management with prescribed medications
Temporary blurred vision or tearing; improvements as the healing progresses
Consistent use of cold compresses and prescribed ointments/liquid medications to aid in recovery.