Paracentesis of anterior chamber of eye (separate procedure); with removal of aqueous
CPT4 code
Name of the Procedure:
Paracentesis of Anterior Chamber of Eye (Separate Procedure); with Removal of Aqueous
Summary
Paracentesis of the anterior chamber of the eye involves making a small incision to remove aqueous humor (fluid) from the front part of the eye. It is a minor surgical procedure performed to relieve pressure or obtain fluid samples for testing.
Purpose
This procedure addresses increased intraocular pressure (IOP) due to conditions like acute glaucoma or infections. The goal is to alleviate pressure, relieve pain, and prevent damage to the optic nerve, thereby preserving vision. It may also be used to withdraw fluid for diagnostic purposes.
Indications
- Acute angle-closure glaucoma
- Severe ocular hypertension unresponsive to medication
- Eye infections like endophthalmitis requiring fluid sampling
- Hyphema (blood in the anterior chamber)
- Uveitis with significant IOP elevation
Preparation
- Patients may be asked to stop certain medications like blood thinners.
- No special fasting is typically required.
- Prior to the procedure, diagnostic eye exams and intraocular pressure measurements will be taken.
Procedure Description
- The patient lies down in a sterile setting.
- Local anesthetic drops are applied to numb the eye.
- A speculum may be used to keep the eyelids open.
- Using a fine needle or surgical instrument, the surgeon makes a small incision in the cornea.
- Aqueous humor is carefully drained or sampled.
- The incision is usually self-sealing, but a special dressing or contact lens may be applied if needed.
Duration
This procedure typically takes around 15-30 minutes.
Setting
The procedure is generally performed in an outpatient clinic or a hospital's ophthalmology department.
Personnel
- Ophthalmologist (Eye Surgeon)
- Ophthalmic Nurse
- Anesthesia Specialist (if needed for sedation)
Risks and Complications
- Infection
- Bleeding
- Corneal injury
- Persistent elevated or too low intraocular pressure
- In rare cases, damage to the lens or other eye structures
Benefits
The primary benefit is the immediate reduction of intraocular pressure, which can alleviate pain and prevent further optic nerve damage. Diagnostic fluid analysis can also guide further treatment for infections.
Recovery
- Patients may be prescribed antibiotic or anti-inflammatory eye drops.
- Avoid rubbing the eye and strenuous activities for a few days.
- Follow-up appointments are necessary to monitor eye pressure and healing.
- Most patients recover fully within a few days to a week.
Alternatives
- Medication management for elevated IOP (e.g., eye drops, oral medications)
- Laser therapy procedures like laser iridotomy
- Other surgical options such as trabeculectomy or shunt procedures Each alternative has its own risks and benefits, and suitability depends on the specific medical condition.
Patient Experience
During the procedure, patients will likely feel pressure but should not experience pain due to local anesthesia. Post-procedure, mild discomfort or blurry vision may occur but is typically manageable with prescribed medications.