Corneal wedge resection for correction of surgically induced astigmatism
CPT4 code
Name of the Procedure:
Corneal Wedge Resection
(Technical term: Wedge Resection for Correction of Surgically Induced Astigmatism)
Summary
Corneal wedge resection is a surgical procedure used to correct astigmatism that develops after a previous eye surgery. The surgeon removes a small, wedge-shaped portion of the cornea to reshape it and improve vision.
Purpose
This procedure addresses surgically induced astigmatism, a condition where the cornea becomes irregularly shaped following eye surgery. The goal is to flatten or steepen particular areas of the cornea to restore normal curvature, thereby improving visual acuity.
Indications
- Post-surgical astigmatism resulting from procedures such as cataract surgery or corneal transplant.
- Poor visual acuity that impacts the patient’s daily activities.
- Inability to correct astigmatism with glasses or contact lenses.
Preparation
- Patients may need to fast for a few hours before the procedure.
- Certain medications may need to be adjusted or temporarily stopped.
- Pre-operative assessments may include corneal topography and a comprehensive eye examination.
Procedure Description
- Anesthesia: Local anesthesia is administered to numb the eye.
- Incision: A small incision is made in the cornea.
- Resection: A wedge-shaped section of the corneal tissue is carefully removed.
- Reshaping: The edges of the cornea are sutured together to reshape and smooth the corneal surface.
- Closure: The incision is closed with fine absorbable sutures.
Tools and Equipment: Microscopes, surgical knives, corneal scissors, and sutures.
Duration
The procedure typically takes about 30 to 60 minutes.
Setting
The procedure is performed in an outpatient surgical center or hospital.
Personnel
- Ophthalmic surgeon
- Surgical nurses
- Anesthesiologist (if sedation is used)
Risks and Complications
- Infection
- Overcorrection or undercorrection of the astigmatism
- Corneal scarring
- Temporary or permanent vision changes
- Suture-related complications
Benefits
- Improved vision and quality of life
- Potentially eliminates the need for corrective lenses
- Rapid recovery and minimal discomfort
Recovery
- Use prescribed antibiotic and anti-inflammatory eye drops to prevent infection and reduce inflammation.
- Avoid rubbing the eye and strenuous activities for several weeks.
- Follow-up appointments will be necessary to monitor healing and visual acuity.
Alternatives
- Glasses or contact lenses
- Laser-based procedures like LASIK or PRK
- Intrastromal corneal ring segments (ICRS)
Pros and Cons: While non-surgical options like glasses are less invasive, they may not provide as effective correction as surgery. Laser-based procedures offer precision but may not be suitable for all patients.
Patient Experience
- Mild discomfort or foreign body sensation post-procedure.
- Vision may be blurry initially but typically improves within a few days.
- Pain is generally well-managed with over-the-counter pain relievers and prescribed medications for inflammation and infection prevention.