67218 Destruction of localized lesion of retina (eg, macular edema, tumors), 1 or more sessions; radiation by implantation of source (includes removal of source)

Name of the Procedure:

Destruction of Localized Lesion of Retina (e.g., Macular Edema, Tumors), 1 or More Sessions; Radiation by Implantation of Source (Includes Removal of Source).

Summary

This procedure involves treating localized lesions on the retina, such as macular edema or tumors, using radiation therapy. A radiation source is implanted near the affected area to deliver targeted radiation and is removed after the treatment is complete. This is typically done in multiple sessions, depending on the condition's severity.

Purpose

The procedure is designed to treat localized retinal lesions, which may include conditions like macular edema or retinal tumors. The main goals are to reduce or eliminate the lesion, prevent further damage to the retina, and preserve or improve vision.

Indications

• Macular edema
• Retinal tumors
• Persistent localized swelling or abnormal growths in the retina
• Symptoms such as vision loss, distortion, or spots in the vision

Preparation

• Possible fasting or dietary restrictions before the procedure
• Adjustments to medications as advised by the physician
• Pre-procedure diagnostic tests like imaging studies (optical coherence tomography, fluorescein angiography) and a thorough eye examination

Procedure Description

1. The patient is positioned comfortably, and local anesthesia is applied to numb the eye area.
2. A small incision is made to implant a radiation source close to the retinal lesion.
3. The radiation source emits targeted radiation to the affected area over a series of sessions.
4. After the treatment course is completed, the radiation source is surgically removed.
5. The incision is closed, and the eye is bandaged as necessary.

Equipment may include specialized radiation delivery devices, surgical tools for implantation and removal, and imaging technology for precise placement.

Duration

The entire process, including implantation, radiation sessions, and removal, can span several weeks, with each session lasting from 30 minutes to an hour.

Setting

The procedure is typically performed in a hospital or an outpatient surgical center with specialized ophthalmology and radiology facilities.

Personnel

• Ophthalmic surgeon
• Radiologist
• Anesthesiologist (if sedation is required)
• Nurses and support staff

Risks and Complications

• Common risks: discomfort, swelling, temporary vision changes
• Rare risks: infection, excessive bleeding, radiation damage to nearby tissues, incomplete lesion destruction
• Managing complications involves medications, additional interventions, or follow-up procedures as needed.

Benefits

• Potentially reduces or eliminates retinal lesions
• May improve or preserve vision
• Minimally invasive compared to other surgical options

Recovery

• Post-procedure care includes eye drops, pain management, and protective eyewear.
• Patients may experience mild discomfort and swelling, which typically subsides within a few days.
• Vision improvements may be noticed over several weeks.
• Normal activities can usually be resumed within a week, with follow-up appointments to monitor progress.

Alternatives

• Laser therapy
• Intravitreal injections (medication injected into the eye)
• Traditional surgery for more extensive lesions
• Observation and regular monitoring (in less severe cases)
• Each alternative has its own set of pros and cons, such as differences in invasiveness, recovery time, and effectiveness.

Patient Experience

• During the procedure: minimal pain due to local anesthesia; patients may feel slight pressure.
• After the procedure: mild discomfort, which can be managed with prescribed pain relievers.
• Gradual improvement in symptoms and vision can be expected over the recovery period.
• Regular follow-up is important to ensure the lesion has been successfully treated.