Revision of aqueous shunt to extraocular equatorial plate reservoir; with graft
CPT4 code
Name of the Procedure:
Revision of Aqueous Shunt to Extraocular Equatorial Plate Reservoir; with Graft
Summary
This surgical procedure involves adjusting or revising a previously implanted aqueous shunt connected to an extraocular equatorial plate reservoir. A graft is used to aid in the revision. The aim is to improve the flow of excess eye fluid and reduce intraocular pressure.
Purpose
The main purpose of this procedure is to address complications or inefficiencies in a previously placed aqueous shunt. It helps in managing conditions like glaucoma by lowering intraocular pressure and preventing optic nerve damage, ultimately preserving vision.
Indications
- Uncontrolled intraocular pressure despite initial shunt placement
- Malfunction or blockage of the existing aqueous shunt
- Persistent symptoms of glaucoma
- Evidence of improper positioning of the shunt
- Patients who have failed to respond to other treatments
Preparation
- Fasting for at least 8 hours before the procedure
- Adjustments or temporary cessation of certain medications as advised by the doctor
- Preoperative eye examinations and imaging tests to assess the current status of the shunt
- Discussion of medical history and any allergy information with the healthcare team
Procedure Description
- Anesthesia: Typically performed under local anesthesia with sedation or general anesthesia.
- Incision: A small incision is made over the previous surgical site.
- Shunt Revision: The existing shunt is evaluated. Repositioning, clearing obstructions, or modifying the shunt is performed as needed.
- Graft Placement: A graft (often made of tissue or synthetic material) is sutured into place to aid in the revision and ensure proper function.
- Closure: The surgical site is carefully closed with sutures.
- Monitoring: Intraocular pressure is monitored throughout the procedure to ensure effectiveness.
Duration
The procedure typically takes 1 to 2 hours to complete.
Setting
The procedure is usually conducted in a hospital operating room or a specialized outpatient surgical center.
Personnel
- Ophthalmic surgeon (specialized in eye surgeries)
- Anesthesiologist or nurse anesthetist
- Surgical nurses and technicians
Risks and Complications
- Infection at the surgical site
- Bleeding during or after the surgery
- Shunt displacement or malfunction post-revision
- Scarring or fibrosis affecting the shunt's performance
- Elevated intraocular pressure requiring further treatment
- Vision changes or loss if complications arise
Benefits
- Improved regulation of intraocular pressure
- Enhanced management of glaucoma symptoms
- Potential preservation of optic nerve function and vision
- Reduced need for additional surgeries or interventions in the future
Recovery
- Post-surgical monitoring in a recovery area (usually a few hours)
- Prescribed eye drops to manage inflammation and prevent infection
- Instructions to avoid strenuous activity and heavy lifting for several weeks
- Regular follow-up appointments to monitor intraocular pressure and ensure proper healing
- Gradual resumption of normal activities as advised by the surgeon
Alternatives
- Medication adjustments to manage glaucoma symptoms
- Laser trabeculoplasty or other less invasive procedures
- Additional or different types of aqueous shunts
- Consideration of risks and benefits of each alternative compared to revision surgery
Patient Experience
- Mild discomfort or pressure during the procedure, with adequate anesthesia to manage pain
- Possible mild to moderate discomfort and eye redness post-procedure
- Use of prescribed pain medication and eye drops to enhance comfort and aid healing
- Swelling and vision fluctuations are common initially but typically improve over time
--- This markdown document provides a comprehensive yet concise description of the revision of an aqueous shunt to an extraocular equatorial plate reservoir with a graft, targeting patient understanding while retaining technical accuracy for healthcare use.