Repair of retinal detachment, including drainage of subretinal fluid when performed; cryotherapy
CPT4 code
Name of the Procedure:
Repair of retinal detachment, including drainage of subretinal fluid when performed; cryotherapy
Summary
This procedure involves reattaching the retina to its proper position in the eye using cryotherapy. Cryotherapy involves freezing specific areas of the retina to help seal retinal tears or holes. The procedure may also include draining subretinal fluid to aid in the reattachment.
Purpose
The procedure aims to address a retinal detachment, which occurs when the retina separates from the back of the eye. The primary goals are to reattach the retina, prevent further vision loss, and potentially restore some of the lost vision.
Indications
- Symptoms of retinal detachment such as sudden flashes of light, floaters, or a shadow over part of the visual field.
- Physical examination and diagnostic imaging (e.g., ultrasound, optical coherence tomography) confirming retinal detachment.
- Patients without contraindications to surgery.
Preparation
- Fasting for at least 8 hours before the procedure.
- Adjusting or stopping certain medications as instructed by the healthcare provider.
- Pre-surgical eye examinations including pupil dilation and imaging tests.
Procedure Description
- Anesthesia: The patient is given local or general anesthesia to prevent pain during the procedure.
- Incision: A small incision is made in the eye to access the retina.
- Drainage: Any accumulated subretinal fluid is drained to ease the reattachment of the retina.
- Cryotherapy: A cryoprobe is used to freeze the area surrounding the retinal tear, creating a scar that seals the tear and aids in reattachment.
- Final Steps: The eye is sealed with sutures if necessary, and a protective eye patch is applied.
Duration
The procedure typically takes about 1 to 2 hours.
Setting
The procedure is usually conducted in a hospital or specialized outpatient surgical center.
Personnel
- Ophthalmic surgeon
- Surgical nurses
- Anesthesiologist or nurse anesthetist
- Surgical assistants
Risks and Complications
- Common risks: Bleeding, infection, increased intraocular pressure.
- Rare risks: Recurrence of retinal detachment, cataract formation, vision loss.
- Possible complications: Need for additional surgery, adverse reactions to anesthesia.
Benefits
- Prevents further vision loss due to retinal detachment.
- Potentially restores some lost vision.
- A high success rate in reattaching the retina.
Recovery
- Post-procedure care includes wearing an eye patch and using prescribed eye drops to prevent infection and decrease inflammation.
- Limit strenuous activities to allow proper healing.
- Patients typically resume normal activities within 2 to 4 weeks.
- Follow-up appointments to monitor the healing process.
Alternatives
- Laser photocoagulation: Uses laser to create scars around retinal tears.
- Pneumatic retinopexy: Injection of a gas bubble into the eye to press the retina back in place.
- Scleral buckling: A band is placed around the eye to counteract the forces causing the detachment.
- Vitrectomy: Removal of the vitreous gel to better access the retina.
Patient Experience
During the procedure, the patient remains under anesthesia and should not feel pain. Post-procedure, some discomfort and mild pain are expected, manageable with prescribed pain medication. Vision may be blurry initially but typically improves as the eye heals. Patient comfort is ensured with proper pain management and follow-up care.