Conjunctivoplasty, reconstruction cul-de-sac; with conjunctival graft or extensive rearrangement
CPT4 code
Name of the Procedure:
Conjunctivoplasty, Reconstruction Cul-de-Sac with Conjunctival Graft or Extensive Rearrangement
Summary
Conjunctivoplasty is a surgical procedure aimed at reconstructing the conjunctival area of the eye, specifically the cul-de-sac, using a conjunctival graft or by performing an extensive rearrangement of existing conjunctival tissue.
Purpose
The procedure is designed to address issues such as scarring, tumors, or other abnormalities in the conjunctival area, which can cause discomfort, impede eye movement, or affect vision. The primary goal is to restore normal anatomy and function of the eye.
Indications
- Persistent or severe conjunctival scarring
- Conjunctival tumors
- Trauma-induced conjunctival defects
- Chronic conjunctivitis unresponsive to medical treatment
- Failed previous ocular surgeries affecting the conjunctiva
Preparation
- Patients may need to fast for a certain number of hours before the procedure
- Adjustments to regular medications, such as stopping blood thinners
- Comprehensive eye examination and imaging studies to plan the surgery
- Pre-operative consultation to discuss the procedure, risks, and benefits
Procedure Description
- The patient is positioned, and anesthesia is administered (local or general, depending on the case).
- The surgeon makes a careful incision to access the affected conjunctival area.
- A conjunctival graft may be harvested from a donor site (either from the same eye or the other eye).
- The graft or existing tissue is repositioned and meticulously sewn into place.
- Additional techniques, such as amniotic membrane transplantation, may be employed.
- The surgical area is cleaned and covered with a protective dressing.
Duration
The procedure typically takes about 1 to 3 hours, depending on the complexity.
Setting
Conjunctivoplasty is usually performed in a hospital, outpatient clinic, or specialized surgical center.
Personnel
- Ophthalmic surgeon
- Surgical nurse
- Anesthesiologist (if general anesthesia is used)
- Scrub technician
Risks and Complications
- Infection
- Bleeding
- Graft rejection or failure
- Scarring
- Persistent discomfort or pain
- Unintended damage to surrounding eye structures
- Need for revision surgery
Benefits
- Restoration of normal eye anatomy and function
- Relief from symptoms like discomfort and impaired vision
- Improvement in cosmetic appearance
- Enhanced eye mobility and function
Recovery
- Use of antibiotic and anti-inflammatory eye drops to prevent infection and reduce inflammation
- Avoidance of strenuous activities and eye strain
- Regular follow-up appointments to monitor healing
- Expected recovery time ranges from several weeks to a few months
- Temporary visual disturbances or discomfort is normal
Alternatives
- Non-surgical treatments like medication or eye drops may be explored but are often less effective for severe cases
- Amniotic membrane transplantation alone for less extensive defects
- Repeat or different types of reconstructive surgery depending on specific case requirements
Patient Experience
- During the procedure, if local anesthesia is used, patients will remain awake but should feel no pain, only mild pressure
- Post-procedure, patients may experience discomfort, redness, and swelling, managed with prescribed pain relief
- Detailed post-operative care instructions will be provided to ensure optimal recovery and comfort.