Severing adhesions of anterior segment of eye, incisional technique (with or without injection of air or liquid) (separate procedure); corneovitreal adhesions
CPT4 code
Name of the Procedure:
Severing Adhesions of Anterior Segment of Eye, Incisional Technique (with or without Injection of Air or Liquid); Corneovitreal Adhesions
Summary
This procedure involves surgically cutting adhesions (bands of scar tissue) that have formed between the cornea and the vitreous humor (the gel-like substance filling the eye). It uses an incisional technique and sometimes includes the injection of air or liquid to assist in the process.
Purpose
The procedure aims to remove adhesions that can obscure vision, cause eye pain, or lead to further ocular complications. The goal is to restore or improve vision and alleviate discomfort caused by these adhesions.
Indications
- Decreased vision due to corneovitreal adhesions.
- Eye pain associated with adhesions.
- Evidence of corneovitreal adhesions observed through diagnostic imaging or examination.
- Patients with conditions such as trauma, inflammation, or previous eye surgery that have led to the formation of these adhesions.
Preparation
- Patients may be instructed to fast for several hours before the procedure.
- Adjustment or discontinuation of certain medications upon the doctor's advice.
- Comprehensive eye examination and imaging tests to assess the extent of the adhesions.
- Possible blood tests to ensure patient suitability for surgery.
Procedure Description
- Anesthesia: Local or general anesthesia is administered based on the patient's condition and procedure requirements.
- Incision: A small incision is made in the cornea to access the adhesions.
- Severing Adhesions: Specialized instruments are used to carefully cut the adhesions between the cornea and the vitreous humor.
- Injection (if applicable): Air or liquid might be injected into the eye to better visualize or assist in separating the adhesions.
- Closure: The incisions are closed, often with dissolvable sutures, if necessary.
- Post-procedure: Antibiotic and anti-inflammatory eye drops are applied to prevent infection and reduce inflammation.
Duration
The procedure typically takes about 30 to 60 minutes to complete.
Setting
It is usually performed in an outpatient surgical center or a hospital's ophthalmology department.
Personnel
- Ophthalmic surgeon
- Anesthesiologist (if general anesthesia is used)
- Surgical nurses
- Ophthalmic technician
Risks and Complications
- Infection
- Bleeding
- Increased intraocular pressure
- Damage to other eye structures
- Recurrence of adhesions
- Visual disturbances or vision loss in rare cases
Benefits
- Improved visual acuity.
- Relief from eye pain or discomfort.
- Prevention of further eye complications associated with adhesions.
- Benefits can often be seen within weeks of the procedure.
Recovery
- Patients may need to rest for a few days post-procedure.
- Antibiotic and anti-inflammatory eye drops are continued as prescribed.
- Follow-up appointments are crucial to monitor the healing process.
- Temporary restrictions on activities that may strain the eyes or increase infection risk.
Alternatives
- Non-surgical management with medications to reduce inflammation.
- Observation if adhesions are not significantly affecting vision or causing discomfort.
- Laser treatment, though it may be less effective for certain adhesions.
Patient Experience
- Patients may feel slight pressure but should not experience pain during the procedure due to anesthesia.
- Mild discomfort or soreness is common post-procedure, which can be managed with prescribed medications.
- Vision may be blurry immediately after the procedure but should gradually improve as healing progresses.