66920 Removal of lens material; intracapsular

Name of the Procedure:

Removal of lens material; intracapsular (also known as Intracapsular Cataract Extraction or ICCE)

Summary

Intracapsular Cataract Extraction is a surgical procedure where the entire lens of the eye, including the surrounding capsule, is removed to treat cataracts. Cataracts are a clouding of the lens that affects vision.

Purpose

The procedure is performed to improve vision impaired by cataracts. The goal is to remove the cloudy lens and, in most cases, replace it with an artificial intraocular lens to restore clear vision.

Indications

• Significant vision impairment due to cataracts
• Inability to perform daily activities because of poor vision
• Presence of cataract-related complications, such as lens dislocation
• Cases where extracapsular cataract extraction is not suitable

Preparation

• Patients are usually required to fast for several hours before the procedure.
• Certain medications may need to be adjusted or discontinued.
• Pre-operative assessments include a complete eye exam, measurements of the eye, and blood tests to ensure fitness for surgery.

Procedure Description

1. Anesthesia: Local anesthesia is administered to numb the eye, sometimes accompanied by a sedative to help the patient relax.
2. Incision: A small incision is made on the cornea.
3. Removal: The surgeon removes the entire lens along with the capsule surrounding it in one piece using specialized instruments.
4. Artificial Lens: In most cases, an intraocular lens (IOL) is implanted to replace the natural lens.
5. Closure: The incision may be closed with sutures or left to heal on its own, depending on the type of surgery.

Duration

The procedure typically takes about 30 to 60 minutes.

Setting

This procedure is performed in a hospital, outpatient surgical center, or specialized eye clinic.

Personnel

• Ophthalmic Surgeon (primary surgeon)
• Anesthesiologist or Nurse Anesthetist (for anesthesia management)
• Surgical Nurses and Technicians

Risks and Complications

• Infection
• Bleeding
• Increased intraocular pressure
• Retinal detachment
• Swelling of the cornea or retina
• Displacement of the implanted lens
• Rarely, loss of vision

Benefits

Patients can expect significant improvement in vision, often immediately after the procedure. Clear vision can resume within a few days, although full recovery might take a few weeks.

Recovery

• Use of prescribed eye drops to prevent infection and inflammation.
• Avoiding strenuous activities and heavy lifting for a few weeks.
• Wearing an eye shield while sleeping to protect the eye.
• Follow-up appointments to monitor the healing process.

Alternatives

• Extracapsular Cataract Extraction (where only the lens is removed but the capsule is left intact).
• Phacoemulsification (ultrasound is used to break up the lens for removal).
• Non-surgical options like stronger eyeglasses or magnifying lenses may be considered but are less effective for significant cataracts.

Patient Experience

During the procedure, the patient will remain awake but numbed, feeling minimal discomfort. After the surgery, mild discomfort or itching is expected but usually managed well with medication. Most patients report rapid improvement in vision and can resume normal activities within a few weeks, following their doctor's guidelines for a smooth recovery.