66852 Removal of lens material; pars plana approach, with or without vitrectomy

Name of the Procedure:

Removal of lens material; pars plana approach, with or without vitrectomy

Summary

This procedure involves removing the lens material from the eye using a pars plana approach, which may include removing the vitreous gel (vitrectomy). It is typically performed to address issues such as cataract complications or retained lens fragments.

Purpose

The procedure aims to treat complications arising from cataracts or other eye conditions leading to lens material retention. It helps restore vision, reduce symptoms, and prevent further eye damage.

Indications

• Presence of cataract fragments after cataract surgery
• Retained lens material causing inflammation or increased intraocular pressure
• Complications from previous eye surgeries
• Conditions like lens dislocation or severe eye trauma

Preparation

• Fasting for at least 6-8 hours prior to the procedure
• Adjustments in medication, especially blood thinners, as advised by the doctor
• Pre-operative eye examination and imaging tests

Procedure Description

1. The patient is administered local or general anesthesia.
2. A small incision is made in the pars plana (the part of the eye near the iris).
3. Special instruments are used to remove the lens material; an advanced vitrectomy machine may be used if vitreous gel removal is required.
4. The eye is then cleaned and closed, often self-sealing or with sutures.
5. Post-operative medications like antibiotics or steroids may be administered to prevent infection and inflammation.

Tools and technology used include:

• Microscopic surgical instruments
• Vitrectomy machine
• Microscopes for visual guidance

Duration

The procedure typically takes 1 to 2 hours.

Setting

It is performed in a hospital or outpatient surgical center.

Personnel

• Ophthalmic surgeon
• Anesthesiologist (if general anesthesia is used)
• Surgical nurses and technicians

Risks and Complications

• Infection
• Bleeding
• Increased intraocular pressure
• Retinal detachment
• Recurrent need for additional surgeries
• Inflammation

Benefits

Restoration of vision clarity, relief from symptoms such as pain and inflammation, and prevention of further eye complications. Benefits are usually realized within a few weeks post-operation.

Recovery

• Use of prescribed eye drops and medications
• Wearing an eye patch initially to protect the eye
• Avoiding heavy lifting and strenuous activities for a few weeks
• Regular follow-up appointments to monitor healing

Alternatives

• Observation if the symptoms are mild and not affecting vision significantly
• Medications to manage inflammation and intraocular pressure
• Other surgical approaches depending on the exact nature of the lens material problem

Patient Experience

Patients may feel nervous before the procedure but are generally made comfortable with anesthesia. Post-procedure, they might experience mild discomfort, soreness, or blurred vision temporarily. Pain management can be effectively handled with medications, and most patients experience significant improvement in their vision soon after the recovery period.