Destruction of extensive or progressive retinopathy (eg, diabetic retinopathy), cryotherapy, diathermy
CPT4 code
Name of the Procedure:
Destruction of Extensive or Progressive Retinopathy (e.g., Diabetic Retinopathy), Cryotherapy, Diathermy
Summary
This procedure involves treating severe or worsening retinopathy, commonly seen in diabetic patients, by using techniques like cryotherapy (freezing) or diathermy (heat). These methods help destroy problematic tissue in the retina to prevent further visual impairment.
Purpose
The procedure aims to address the complications of retinopathy, a condition where the retina is damaged due to high blood sugar levels. The goals are to prevent further vision loss, stabilize the condition, and potentially improve vision.
Indications
- Diagnosed with advanced or progressive retinopathy, especially diabetic retinopathy.
- Symptoms include blurred vision, seeing floaters, poor night vision, or a sudden loss of vision.
- Patients whose condition cannot be managed effectively with medications or other non-invasive treatments.
Preparation
- Fasting may not be required, but this should be confirmed with the doctor.
- Certain medications might need to be adjusted; patients should consult their healthcare provider.
- Pre-procedure assessments could include visual acuity tests, retinal exams, and imaging studies like fluorescein angiography.
Procedure Description
- The patient is usually given a topical anesthetic to numb the eye.
- Cryotherapy involves applying a freezing probe to the eye, targeting the retina.
- Diathermy uses an electric current to produce heat, cauterizing the damaged areas.
- The procedure is typically performed with specialized instruments under direct visualization using an ophthalmoscope.
- Post-procedure, an eye patch may be applied to protect the treated eye.
Duration
The entire procedure generally lasts about 30 to 60 minutes.
Setting
The procedure is commonly conducted in an outpatient clinic, a specialized eye clinic, or a hospital setting.
Personnel
- Ophthalmologist (Eye Surgeon)
- Surgical Nurse
- Supporting medical staff for patient preparation and monitoring
Risks and Complications
- Common risks: Temporary discomfort, mild pain, or redness.
- Rare risks: Infection, bleeding inside the eye, retinal detachment, or cataract formation.
- Complications are usually manageable and should be discussed with the ophthalmologist.
Benefits
- Prevention of further vision loss.
- Potential improvement in vision clarity.
- Enhanced quality of life by stabilizing the condition.
Recovery
- Patients may experience temporary blurred vision or discomfort.
- Use prescribed eye drops to reduce inflammation and prevent infection.
- Avoid strenuous activities and protect the eye from injury for a few days.
- Follow-up appointments are crucial to monitor the recovery process.
Alternatives
- Laser photocoagulation: Uses laser to seal or destroy blood vessels.
- Vitrectomy: Surgical removal of the vitreous gel from the eye.
- Anti-VEGF injections: Medications injected into the eye to reduce blood vessel growth.
- Each alternative has its pros and cons, such as varying degrees of invasiveness, recovery times, and suitability depending on the specific case.
Patient Experience
- During the procedure: Minimal pain due to anesthetic use, but some pressure might be felt.
- After the procedure: Mild discomfort, eye redness, and blurry vision are typical but usually subside within a few days.
- Pain management: Over-the-counter pain relievers and prescribed medications if necessary.