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Corneal relaxing incision for correction of surgically induced astigmatism

CPT4 code

Name of the Procedure:

Corneal Relaxing Incision (CRI) for Correction of Surgically Induced Astigmatism
Technical Terms: Astigmatic Keratotomy (AK)

Summary

A corneal relaxing incision is a minor surgical procedure to correct astigmatism that develops after eye surgery, such as cataract surgery. By making tiny incisions on the cornea, the surgeon can change its shape, improving the patient's vision.

Purpose

The procedure addresses surgically induced astigmatism, where the cornea is not perfectly round, causing blurred or distorted vision. The goal is to reshape the cornea to improve visual clarity and reduce dependence on corrective lenses.

Indications

  • Patients experiencing blurred or distorted vision post-cataract surgery.
  • Diagnosed with significant surgically induced astigmatism.
  • Ineffectiveness or intolerance of corrective lenses or contact lenses.

Preparation

  • Patients might need to stop taking certain medications like blood thinners.
  • Avoid eating or drinking for a specified time before the procedure.
  • Pre-procedural eye examination and measurement of corneal curvature.

Procedure Description

  1. The procedure is typically performed on an outpatient basis.
  2. Local anesthesia is administered to numb the eye.
  3. The surgeon uses a precise blade or femtosecond laser to create small incisions in the cornea.
  4. These incisions are strategically placed to relax the corneal tissue, thus altering its shape and correcting astigmatism.
  5. The procedure is usually completed within a few minutes.

Duration

The procedure typically takes 10-20 minutes per eye.

Setting

Outpatient clinic or surgical center.

Personnel

  • Ophthalmologist or eye surgeon
  • Surgical nurse
  • Anesthesiologist or anesthesia nurse (if sedation is used)

Risks and Complications

  • Infection
  • Overcorrection or undercorrection of astigmatism
  • Scarring of the cornea
  • Temporary blurred vision
  • Dry eyes

Benefits

  • Improved overall clarity of vision.
  • Reduction or elimination of astigmatism.
  • Decreased dependence on glasses or contact lenses.
  • Benefits are usually noticeable within a few days to a few weeks.

Recovery

  • Mild discomfort and light sensitivity can be expected for a few days.
  • Use of prescribed antibiotic or anti-inflammatory eye drops to prevent infection and aid healing.
  • Avoid rubbing the eyes and strenuous activities.
  • Follow-up appointments to monitor the healing process.
  • Full recovery typically occurs within a few weeks.

Alternatives

  • Laser vision correction (LASIK or PRK)
  • Toric intraocular lenses
  • Use of corrective lenses (glasses or contacts) Each alternative has its pros and cons. For instance, laser procedures might offer more precise correction but come with their risks, while glasses and contacts are non-invasive but may not suit everyone.

Patient Experience

During the procedure, patients will feel some pressure but no pain due to local anesthesia. Post-procedure, there might be mild discomfort, a gritty sensation, and sensitivity to light. Pain management includes over-the-counter pain relievers and prescribed eye drops for comfort.

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