Repair of entropion; excision tarsal wedge

CPT4 code

Name of the Procedure:

Repair of Entropion; Excision Tarsal Wedge
Common name(s): Entropion surgery, Tarsal wedge excision

Summary

Entropion surgery involves correcting a condition where the eyelid turns inward, causing the eyelashes to rub against the eye. This is achieved by removing a small, wedge-shaped section of the eyelid to restore its normal position.

Purpose

This procedure addresses entropion, a condition where the eyelid turns inward. The goal is to prevent irritation and damage to the eye surface by repositioning the eyelid and stopping the eyelashes from rubbing against the eye.

Indications

Persistent eye irritation or discomfort
Redness and tearing
Repeated corneal infections or ulcerations
Scarring or damage to the cornea caused by inward-turned eyelashes

Preparation

Patients may need to avoid eating or drinking for several hours before the procedure.
Adjustments to current medications as advised by the doctor.
A thorough eye examination and possibly imaging tests to assess the structure of the eyelid.

Procedure Description

The patient is usually given local anesthesia to numb the eyelid.
The surgeon makes an incision in the eyelid and removes a small, wedge-shaped section from the tarsal plate (a dense, fibrous layer within the eyelid) to correct its positioning.
The edges of the incision are then stitched together to secure the eyelid in its new position.
Antibiotic ointments may be applied to prevent infection.

Duration

The procedure typically takes about 30-60 minutes.

Setting

This surgery is often performed in an outpatient clinic or ambulatory surgical center.

Personnel

Ophthalmic surgeon
Surgical nurse
Anesthesiologist (if general anesthesia is needed)

Risks and Complications

Infection
Bleeding
Scarring
Asymmetrical eyelids
Recurrence of entropion
Temporary or permanent changes in eyelid position

Benefits

Relief from eye irritation and discomfort
Prevention of further corneal damage
Improved eye health and vision
Most patients notice improvement within days to weeks following surgery.

Recovery

Patients may be advised to use antibiotic ointments and avoid touching the eye.
Swelling and bruising are common but usually subside within a week.
Stitches may need to be removed within 7-10 days.
Follow-up appointments to monitor healing.

Alternatives

Non-surgical treatments, such as lubricating eye drops and ointments
Temporary solutions like botulinum toxin injections
Eyelid taping or use of specialized contact lenses
Each alternative has its own pros and cons, often providing temporary relief rather than a permanent fix.

Patient Experience

Some discomfort and swelling post-procedure, manageable with prescribed medication.
Avoid rubbing the eyes and protect them from irritants.
Use cold compresses to reduce swelling.
Most patients experience significant relief and improved comfort after a successful recovery.