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Iridectomy, with corneoscleral or corneal section; sector for glaucoma (separate procedure)
CPT4 code
Name of the Procedure:
Iridectomy, with corneoscleral or corneal section; sector for glaucoma
Summary
An iridectomy is a surgical procedure that involves removing a small part of the iris (the colored part of the eye) to relieve intraocular pressure, often used to treat glaucoma.
Purpose
The procedure aims to reduce elevated intraocular pressure that is typically caused by glaucoma, thereby preventing further damage to the optic nerve and preserving vision.
Indications
- Presence of angle-closure glaucoma
- Elevated intraocular pressure unresponsive to medications
- Narrow-angle eyes that pose a risk for acute glaucoma
- Failed laser iridotomy or other less invasive treatments
Preparation
- Fasting for several hours before the procedure may be required
- Stopping specific medications as advised by the surgeon
- Routine diagnostic tests like visual acuity assessment, intraocular pressure measurement, and pupil dilation exams
Procedure Description
- The patient receives local or general anesthesia to numb the eye.
- A small incision is made in the cornea or corneoscleral junction.
- A tiny section of the iris is removed to create a new pathway for fluid drainage.
- The incision is closed with small sutures if necessary.
- Antibiotic and anti-inflammatory eye drops are administered to prevent infection and inflammation.
Duration
The procedure typically takes about 30 to 60 minutes.
Setting
The procedure is usually performed in an outpatient surgical center or hospital.
Personnel
- Ophthalmic surgeon
- Anesthesiologist or nurse anesthetist (if general anesthesia is used)
- Surgical nurses and technicians
Risks and Complications
- Infection
- Bleeding
- Increased intraocular pressure
- Damage to other eye structures
- Need for additional surgery
- Vision changes or loss
Benefits
- Reduction in intraocular pressure
- Prevention of further optic nerve damage
- Stabilization or improvement of vision
- Immediate pressure relief in some cases
Recovery
- Use of prescribed antibiotic and anti-inflammatory eye drops
- Avoid strenuous activities and heavy lifting
- Follow-up appointments to monitor eye pressure and healing
- Most patients can resume normal activities within a week
Alternatives
- Medications to lower intraocular pressure
- Laser peripheral iridotomy
- Other surgical interventions like trabeculectomy
- Conservative management without surgery, though less effective for certain types of glaucoma
Patient Experience
- Mild to moderate eye discomfort and blurred vision immediately following the procedure
- Pain management with prescribed analgesics
- Sensation of dryness or grittiness in the eye for a few days
- Gradual return to normal vision within a few weeks