Reconstruction of eyelid, full thickness by transfer of tarsoconjunctival flap from opposing eyelid; total eyelid, lower, 1 stage or first stage
CPT4 code
Name of the Procedure:
Reconstruction of Eyelid, Full Thickness by Transfer of Tarsoconjunctival Flap from Opposing Eyelid; Total Eyelid, Lower, 1 Stage or First Stage
Summary
This procedure involves reconstructing a damaged or missing part of the lower eyelid by transferring tissue (tarsoconjunctival flap) from the patient's upper eyelid. This approach helps restore the full thickness of the eyelid, ensuring functional and aesthetic repair.
Purpose
The procedure addresses significant defects in the lower eyelid due to trauma, congenital conditions, or surgical removal of tissue (e.g., from cancer). It aims to restore normal eyelid structure and function, protecting the eye and enhancing appearance.
Indications
- Severe trauma to the lower eyelid
- Congenital defects affecting the lower eyelid
- Tissue loss following tumor excision
- Conditions leading to eyelid deformities or dysfunction
Preparation
- Pre-procedure consultation and eye examination
- Fasting for at least 6 hours before the procedure
- Discontinuation or adjustment of certain medications as advised by the healthcare provider
- Preoperative blood tests and imaging studies, if needed
Procedure Description
- The patient is placed under local anesthesia with sedation or general anesthesia.
- The surgeon designs and marks the flap on the upper eyelid.
- The tarsoconjunctival flap is carefully dissected and transferred to the lower eyelid defect.
- The flap is sutured in place, ensuring proper alignment and viability.
- The donor site (upper eyelid) is also closed with sutures.
- Dressings or bandages may be applied to protect the surgical area.
Duration
The procedure typically takes 1 to 2 hours, depending on the complexity of the defect.
Setting
The procedure is performed in a hospital or a specialized surgical center.
Personnel
- Ophthalmic surgeon or plastic surgeon specialized in eyelid reconstruction
- Surgical nurses
- Anesthesiologist
Risks and Complications
- Infection at the surgical site
- Bleeding or hematoma formation
- Flap failure or necrosis
- Scarring and aesthetic dissatisfaction
- Altered sensation or numbness in the eyelids
Benefits
- Restoration of eyelid function and appearance
- Protection of the eye from injury and irritation
- Improved vision and comfort
Recovery
- Application of prescribed eye ointments and antibiotics
- Cold compresses to minimize swelling
- Pain management with prescribed medications
- Avoidance of strenuous activities for at least 1-2 weeks
- Follow-up appointments for suture removal and monitoring of flap healing
Alternatives
- Skin grafting or use of artificial materials
- Non-surgical options, which may provide less optimal results
- The choice of alternatives depends on the specific condition and the extent of the defect.
Patient Experience
- Mild discomfort and swelling post-procedure
- Prescription pain medications may be required
- Regular follow-ups to ensure proper healing and function
- Improvement in eyelid appearance and function typically observed within a few weeks