Removal of lens material; intracapsular, for dislocated lens
CPT4 code
Name of the Procedure:
Removal of lens material; intracapsular, for dislocated lens
Common Name(s): Intracapsular lens extraction (ICLE), Dislocated lens removal
Technical Term: Intracapsular cataract extraction (ICCE)
Summary
This procedure involves removing the entire lens of the eye, including the capsule, when it has become dislocated. It is performed to restore vision and prevent complications related to the dislocated lens.
Purpose
Medical Condition: Dislocated lens (ectopia lentis)
Goals/Outcomes: Restore clear vision, eliminate symptoms like double vision or vision impairment, and prevent potential complications such as increased intraocular pressure.
Indications
Symptoms/Conditions: Vision impairment, double vision, pain, eye pressure, or complications from the dislocated lens.
Patient Criteria: Patients with confirmed lens dislocation that affects their quality of life or poses a threat to eye health.
Preparation
Pre-Procedure Instructions: Patients may be advised to fast for several hours before the procedure. They may need to stop taking certain medications as directed by their doctor.
Diagnostic Tests/Assessments: Eye examination, imaging tests like ultrasound or CT scans, and possibly blood tests to evaluate general health.
Procedure Description
- Anesthesia: Local anesthesia or sedative may be administered to numb the eye and help the patient relax.
- Incision: A small incision is made in the eye.
- Lens Removal: Special tools are used to carefully remove the dislocated lens, including the capsule.
- Replacement (if needed): An artificial intraocular lens (IOL) may be implanted.
- Incision Closure: The incision is closed, often with small, self-dissolving stitches.
Tools/Equipment: Surgical instruments (forceps, scissors, phacoemulsification machine if replacement lens inserted, etc.), operating microscope.
Duration
Typically takes about 1 to 2 hours.
Setting
Performed in a hospital operating room or specialized eye surgery center.
Personnel
Healthcare Professionals: Ophthalmic surgeon, anesthesiologist or nurse anesthetist, surgical nurses, and possibly an ophthalmic assistant.
Risks and Complications
- Common: Infection, bleeding, inflammation
- Rare: Retinal detachment, chronic eye pain, vision loss, increased intraocular pressure.
Management: Postoperative medications (antibiotics, anti-inflammatory drugs) and follow-up care to monitor and manage complications.
Benefits
Restoration of vision, relief from symptoms of lens dislocation such as double vision and pain, prevention of further eye issues.
Realization of Benefits: Vision improvement typically begins soon after surgery, with continued improvement over a few weeks.
Recovery
Post-Procedure Care: Use prescribed eye drops, avoid strenuous activities, keep the eye clean and protected.
Expected Recovery Time: Several days to a few weeks, depending on individual healing.
Restrictions/Follow-Up: Regular follow-up appointments to monitor healing and address any issues. Physical restrictions to avoid complications.
Alternatives
Other Options:
- Observation and regular monitoring for mild cases
- Lens repositioning surgery
- Contact lenses or glasses to correct vision
Pros and Cons:
- Observation may be less invasive but doesn't address the problem
- Lens repositioning can be less invasive but may not be suitable for everyone
- Contact lenses/glasses are non-surgical; however, they don't correct the underlying issue.
Patient Experience
During the procedure, patients are typically awake but sedated and will not feel pain due to local anesthesia. Post-operatively, there may be some discomfort, mild pain, and temporary vision blurriness. Pain management strategies include prescribed medications and protective measures to ensure comfort and healing.