CPT® Code 67911

The procedure described by CPT® Code 67911 pertains to the correction of lid retraction, a condition affecting the upper and lower eyelids. Lid retraction occurs when the eyelids are unable to close completely, leading to exposure of the sclera, which is the white part of the eye. In the case of lower eyelid retraction, this condition is often caused by a relaxation of the support system of the eye, as well as shrinkage of the tissue layers, including skin, muscle, and retractor muscles. This can result from various factors such as aging, thyroid disease, or complications arising from previous surgical procedures like lower eyelid blepharoplasty. Conversely, upper lid retraction typically results in the exposure of the sclera above the cornea and is most frequently associated with thyroid disease. The specific surgical approach for correcting lid retraction is determined by whether the upper or lower eyelid is affected, as well as the underlying cause, the severity of the retraction, and individual patient characteristics. For upper lid retraction, correction may involve a transconjunctival or transcutaneous approach, where Muller's muscle is exposed and excised, and the levator aponeurosis may also be resected. Adjustable sutures are utilized to fine-tune the eyelid position, and in some cases, an autogenous graft from the hard palate or synthetic graft material may be employed to provide support and adjust the eyelid height. In contrast, lower lid retraction correction is performed through a transconjunctival approach, where the support structures of the lower lid may be reconstructed or reinforced. This repair may necessitate skin grafting, the use of another type of autogenous graft, or reinforcement with synthetic materials, followed by careful adjustment of the lower lid height and layered closure of the surgical wound.