68325 Conjunctivoplasty; with buccal mucous membrane graft (includes obtaining graft)

Name of the Procedure:

Conjunctivoplasty with buccal mucous membrane graft (includes obtaining graft)

Summary

In simple terms, Conjunctivoplasty is a surgical procedure where the tissue of the eye, specifically the conjunctiva, is repaired or reconstructed using a graft taken from the inside of the cheek (buccal mucous membrane). This helps to restore or improve the function and appearance of the eye.

Purpose

Conjunctivoplasty is performed to address damage or diseases affecting the conjunctiva—the thin membrane covering the white part of the eye and the inside of the eyelids. The goals of the procedure include:

• Restoring normal eye function.
• Improving comfort and reducing symptoms such as irritation or dryness.
• Enhancing the cosmetic appearance of the eye.

Indications

This procedure is indicated for:

• Patients with severe conjunctival scarring due to diseases or injuries.
• Individuals with recurring pterygium (a benign growth on the eye) that requires surgical intervention.
• Conditions like symblepharon (adhesion of the eyelid to the eyeball) or conjunctival tumors.

Preparation

• The patient may need to fast for a few hours before the procedure.
• Pre-procedure assessment includes a thorough eye examination and medical history review.
• The patient may be advised to stop certain medications that could increase bleeding risk.

Procedure Description

1. The patient receives local or general anesthesia to ensure comfort.
2. The surgeon procures a graft from the patient's buccal mucosa (inner cheek lining).
3. The damaged or diseased conjunctival tissue is carefully excised or prepared.
4. The buccal mucous membrane graft is then meticulously sutured to the affected area of the eye.
5. The donor site (inner cheek) is also sutured to promote healing.

Common tools and equipment:

• Surgical instruments like scissors, forceps, and sutures.
• An operating microscope for precision.
• Anesthesia equipment for sedation or pain management.

Duration

The procedure typically takes 1 to 2 hours, depending on the complexity.

Setting

The procedure is generally performed in a hospital or a specialized outpatient surgical center.

Personnel

• Ophthalmic surgeon.
• Anesthesiologist (if general anesthesia is used).
• Surgical nurses and assistants.

Risks and Complications

• Common risks include infection, bleeding, and discomfort.
• Rare complications may involve graft rejection, lasting damage to the cheek or eye, and scarring.
• Proper follow-up care can manage most complications effectively.

Benefits

• Improved eye function and appearance.
• Relief from symptoms like dryness, irritation, or pain.
• Long-term results that restore normalcy to daily activities.

Recovery

• Patients might need to use prescribed eye drops or ointments.
• Follow-up appointments will check for proper healing and graft integration.
• Expect some discomfort in the inner cheek where the graft was taken.
• Recovery time ranges from a few weeks to a couple of months, depending on individual healing rates.

Alternatives

• Non-surgical treatments such as medication or eye drops, though they may not be as effective for severe cases.
• Other surgical options like amniotic membrane grafting, but these may have different risk profiles and success rates.

Patient Experience

• During the procedure, the patient will likely be unaware of the surgical process due to anesthesia.
• Post-surgery, the patient may experience mild to moderate pain or discomfort, manageable with medications.
• Vision may be temporarily blurred as the eye heals, and there will be some discomfort at the graft site in the cheek.