67005 Removal of vitreous, anterior approach (open sky technique or limbal incision); partial removal

Name of the Procedure:

Removal of vitreous, anterior approach (open sky technique or limbal incision); partial removal
Common Name: Partial Anterior Vitrectomy

Summary

A partial anterior vitrectomy is a surgical procedure to remove a portion of the vitreous humor – the clear gel-like substance inside the front part of the eye. This is usually done through an incision at the limbus or via an open sky technique.

Purpose

This procedure primarily addresses issues such as vitreous hemorrhage, retained lens fragments after cataract surgery, or complications from previous eye surgeries. The goals are to restore vision, reduce inflammation, and prevent further complications.

Indications

• Vitreous haemorrhage causing vision obstruction
• Retained lens fragments post-cataract surgery
• Eye trauma leading to vitreous issues
• Complications from previous eye surgeries such as cataract removal

Preparation

• Patients may need to fast for 6-8 hours prior to surgery.
• Adjustments in medications, particularly blood thinners.
• Pre-surgical eye examination and possibly imaging tests to assess the condition of the vitreous and retina.

Procedure Description

1. The patient is given local or general anesthesia.
2. An incision is made at the limbus or via an open sky technique.
3. Special surgical instruments are used to remove the damaged or problematic portion of the vitreous.
4. In some cases, additional procedures like lens fragment removal might be combined.
5. The incision is then closed, and the eye might be covered with a protective shield.

Duration

The procedure typically takes 30 minutes to 1 hour.

Setting

Performed in a hospital or outpatient surgical center under sterile conditions.

Personnel

• Ophthalmic Surgeon
• Nursing staff
• Anesthesiologist or nurse anesthetist (if general anesthesia is used)

Risks and Complications

• Infection
• Bleeding
• Retinal detachment
• Raised intraocular pressure
• Formation of cataracts
• Vision may be temporarily blurred after surgery

Benefits

• Improved vision clarity
• Reduction in pain or discomfort caused by the condition
• Prevention of further complications
• Benefits are usually noticeable shortly after the procedure, though full recovery might take longer.

Recovery

• Patients may need to use eye drops to prevent infection and inflammation.
• Avoid strenuous activities and heavy lifting.
• Follow-up appointments to monitor recovery and eye health.
• Full recovery can take several weeks.

Alternatives

• Medications to manage symptoms, although they may not be as effective.
• Observation, particularly if the symptoms are mild and not progressing.

Patient Experience

• Patients might feel some discomfort post-operatively but pain is usually manageable with prescribed medications.
• Mild blurriness or irritation in the eye is common but typically resolves.
• Regular follow-up visits are necessary to ensure proper healing and monitor for any complications.