Snip incision of lacrimal punctum
CPT4 code
Name of the Procedure:
Snip Incision of Lacrimal Punctum
Common Name(s): Punctal Snip, Lacrimal Punctal Snip
Technical Terms: Punctoplasty, Punctal Snip Procedure
Summary
The Snip Incision of Lacrimal Punctum is a minor surgical procedure to enlarge the opening of the tear ducts (lacrimal puncta). This helps alleviate blockages or narrowings that impede tear drainage from the eye.
Purpose
The procedure addresses conditions such as punctal stenosis (narrowing of the lacrimal puncta) to improve tear drainage. It aims to reduce symptoms like excessive tearing (epiphora) and recurrent eye infections.
Indications
- Chronic tearing (epiphora)
- Recurrent eye infections or inflammation
- Narrow or clogged lacrimal puncta
- Failed response to non-surgical treatments
Preparation
- No special preparation is usually required.
- The patient should disclose any medications or health conditions to the doctor.
- A local anesthetic is typically used, so fasting is not necessary.
Procedure Description
- Anesthesia: Local anesthetic drops are applied to numb the eye area.
- Preparation: The eye and surrounding area are sterilized.
- Incision: A small scissors-like instrument is used to make a tiny cut in the lacrimal punctum.
- Adjustment: The opening is gently widened to improve tear drainage.
- Completion: The procedure is quick, and no stitches are typically required.
Tools Used:
- Local anesthetic eye drops
- Punctal dilators
- Scissors specially designed for the procedure
Duration
The procedure typically takes about 15-20 minutes.
Setting
Performed in an outpatient clinic or office setting.
Personnel
- Ophthalmologist or Oculoplastic surgeon
- Nurse or medical assistant
Risks and Complications
Common risks:
- Mild discomfort
- Temporary swelling or redness
Rare risks:
- Infection
- Excessive tearing if the punctum remains too wide
- Scarring
Management involves follow-up with the ophthalmologist for any persistent symptoms.
Benefits
- Improved tear drainage
- Reduction in tearing and eye discomfort
- Prevention of recurrent eye infections
Benefits are often noticeable shortly after the procedure.
Recovery
- Mild discomfort managed with over-the-counter pain relievers.
- Avoid rubbing the eyes; follow specific doctor instructions.
- Recovery typically takes a few days, with minimal restrictions.
- Follow-up appointments may be scheduled to check on healing.
Alternatives
- Punctal dilation using probes.
- Punctal plugs to temporarily open the tear duct.
- Medications for underlying conditions causing tearing.
Pros/Cons:
- Alternatives may provide temporary relief but not a permanent solution like the snip incision.
- Surgery provides a more lasting effect compared to medications or plugs.
Patient Experience
During the procedure:
- Mild stinging from anesthetic drops.
- Pressure or slight discomfort but no significant pain.
After the procedure:
- Possible mild soreness and redness.
- Eye drops may be prescribed to prevent infection and manage discomfort.
- Normal activities can usually be resumed the next day.