0474T Insertion of anterior segment aqueous drainage device, with creation of intraocular reservoir, internal approach, into the supraciliary space

Name of the Procedure:

Insertion of anterior segment aqueous drainage device, with creation of intraocular reservoir, internal approach, into the supraciliary space

Summary

This procedure involves inserting a device to help drain excess fluid from the front part of the eye, specifically into the space between the sclera and the ciliary body. It helps to create a small reservoir within the eye to manage fluid buildup and alleviate pressure.

Purpose

The procedure is typically performed to treat conditions that involve increased intraocular pressure, such as glaucoma. The goal is to lower the pressure within the eye, prevent further damage to the optic nerve, and preserve vision.

Indications

• Elevated intraocular pressure not controlled by medication
• Severe glaucoma
• Risk of optic nerve damage
• Patients for whom other treatments have been ineffective

Preparation

• The patient may need to fast for a certain period before the procedure.
• It is important to follow instructions regarding medication adjustments, especially blood thinners.
• A thorough eye examination and imaging tests will be conducted prior to the procedure.

Procedure Description

1. The patient is given local anesthesia to numb the eye.
2. A small incision is made in the eye.
3. An aqueous drainage device is carefully inserted into the front part of the eye.
4. The device is placed into the supraciliary space to create a small reservoir for fluid.
5. The incision is closed, and a shield or patch may be placed over the eye to protect it.

Tools and equipment used include microscopic surgical instruments, the drainage device, and possibly advanced imaging tools for precision.

Duration

The procedure typically takes about 30 to 60 minutes.

Setting

It is usually performed in a hospital or an outpatient surgical center.

Personnel

• Ophthalmologist or an eye surgeon
• Nurses
• Anesthesiologist (if sedation is used)

Risks and Complications

• Infection
• Bleeding
• Device dislocation
• Prolonged inflammation
• Vision changes
• Uncontrolled intraocular pressure

Benefits

• Reduction in intraocular pressure
• Prevention of further optic nerve damage
• Preservation of vision
• Recovery of peripheral vision begins within days to weeks

Recovery

• Use of prescribed eye drops to prevent infection and reduce inflammation.
• Avoid rubbing or applying pressure to the eye.
• Follow-up appointments to monitor eye pressure and ensure proper healing.
• Most patients can resume normal activities within a week, but strenuous activities should be avoided for a few weeks.

Alternatives

• Medications (eye drops, oral medications)
• Laser therapy
• Other surgical procedures like trabeculectomy or glaucoma drainage implants

Each alternative has its own set of pros and cons related to effectiveness, recovery time, and risk of complications.

Patient Experience

During the procedure, the patient may feel slight pressure but should not feel pain due to anesthesia. Post-procedure, the eye might feel sore, and vision may be blurry for a short period. Pain management typically involves over-the-counter pain relievers and prescribed eye drops.