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Iridoplasty by photocoagulation (1 or more sessions) (eg, for improvement of vision, for widening of anterior chamber angle)
CPT4 code
Name of the Procedure:
Iridoplasty by Photocoagulation (1 or more sessions) Common name: Laser Iridoplasty
Summary
Laser iridoplasty is a minimally invasive eye procedure that uses a laser to reshape the iris. This is done to improve vision and widen the anterior chamber angle of the eye, which can help in managing certain conditions like narrow-angle glaucoma.
Purpose
The primary goal is to widen the anterior chamber angle to prevent or treat angle-closure glaucoma. It can also improve vision in patients with certain iris abnormalities.
Indications
- Narrow-angle glaucoma or angle-closure glaucoma
- Shallow anterior chamber angle
- Iris abnormalities causing vision issues
- Patients unresponsive to medical therapy
Preparation
- Stop any blood-thinning medications as advised by the doctor.
- Undergo a thorough eye examination and possibly imaging tests like gonioscopy.
- Use prescribed eye drops before the procedure to prepare the eye.
Procedure Description
- The patient is seated in front of a specialized laser machine.
- Eye drops are administered to numb the eye and constrict the pupil.
- A contact lens is placed on the eye to focus the laser.
- The ophthalmologist uses the laser to create small burns on the peripheral iris, which contract and pull the iris away from the drainage angle.
- The procedure typically involves multiple laser applications around the iris.
- Post-procedure eye drops may be administered to control inflammation and intraocular pressure.
Duration
Approximately 10-15 minutes per session.
Setting
Outpatient clinic or ophthalmologist's office.
Personnel
- Ophthalmologist
- Ophthalmic nurse or technician
Risks and Complications
- Mild discomfort or pain during the procedure
- Temporary inflammation or increased intraocular pressure
- Rare risks include bleeding, infection, or damage to the eye structures
Benefits
- Effective widening of the anterior chamber angle
- Prevention of acute angle-closure glaucoma
- Improved vision if iris position was previously obstructed
Recovery
- Use anti-inflammatory and pressure-reducing eye drops as prescribed.
- Avoid strenuous activity for a few days.
- Follow-up visits to monitor eye pressure and healing.
- Most patients can resume normal activities within a day or two.
Alternatives
- Medications to manage intraocular pressure
- Laser peripheral iridotomy
- Surgical procedures like trabeculectomy
Pros and Cons:
- Medications may have side effects and require lifelong use.
- Laser peripheral iridotomy is less invasive but may be less effective for some patients.
- Surgical options carry higher risks and longer recovery times.
Patient Experience
- Patients may feel mild discomfort or a slight burning sensation during the procedure.
- Post-procedure, there can be temporary blurry vision and light sensitivity.
- Pain is usually minimal and managed with topical medications.