Severing adhesions of anterior segment of eye, incisional technique (with or without injection of air or liquid) (separate procedure); posterior synechiae
CPT4 code
Name of the Procedure
Severing Adhesions of Anterior Segment of Eye, Incisional Technique; Posterior Synechiae
Common name(s): Posterior Synechiae Release, Adhesion Severance Surgery
Summary
This procedure involves making a precise surgical incision to sever adhesions (scar tissue) that have formed between the iris and lens of the eye. This is specifically for the treatment of posterior synechiae, where these tissues stick together, potentially with the injection of air or liquid to aid in the process.
Purpose
Posterior synechiae can cause vision problems and increased eye pressure due to the adhesion of the iris to the lens. The goal of this procedure is to restore normal eye anatomy and function, alleviate discomfort, and prevent further complications like glaucoma.
Indications
- Vision impairment due to posterior synechiae
- Elevated intraocular pressure
- Symptoms unresponsive to medical treatments
- High risk of glaucoma or other complications
Preparation
- Patients may be instructed to fast for several hours before the procedure.
- Certain medications like anticoagulants might need to be adjusted.
- An ophthalmic examination and potentially imaging tests to understand the extent of adhesions.
Procedure Description
- The patient will be given local anesthesia to numb the eye.
- An ophthalmic surgeon will make a small incision in the eye's anterior segment using fine surgical instruments.
- Adhesions (synechiae) between the iris and lens are carefully severed.
- Air or liquid may be injected into the anterior chamber of the eye to ensure the structures are properly separated and to facilitate healing.
- The eye is typically covered with a protective shield after the procedure.
Duration
The procedure usually takes about 30 to 60 minutes, depending on the complexity of the adhesions.
Setting
Typically performed in a hospital, outpatient clinic, or a surgical center.
Personnel
- Ophthalmic Surgeon
- Ophthalmic Nurse
- Anesthesiologist or Nurse Anesthetist (for local or sedation anesthesia)
- Surgical Technician
Risks and Complications
- Infection
- Bleeding
- Increased intraocular pressure
- Damage to eye structures
- Incomplete relief requiring additional procedures
Benefits
- Relief from vision impairment due to adhesions
- Reduction in eye pressure
- Lower risk of developing glaucoma
- Improved overall ocular health and function
- Benefits usually realized within a few days to weeks post-procedure
Recovery
- Patients should avoid strenuous activities and protect the eye from injury.
- Use prescribed eye drops to prevent infection and control inflammation.
- Follow-up appointments are necessary for monitoring recovery.
- Recovery time is typically a few weeks, but vision may improve earlier.
Alternatives
- Medical management with anti-inflammatory medications and eye drops
- Laser synechiolysis for non-severe cases
- Risks and benefits of alternatives may vary; medical management might be less invasive but less effective in severe cases.
Patient Experience
- Mild discomfort or pressure during the procedure due to local anesthesia; sedation may be used if necessary.
- Post-procedure, expect mild pain or discomfort, managed with prescribed painkillers.
- Temporary blurry vision as the eye heals.
- Attend regular follow-up visits to monitor progress and manage any post-operative issues.