Repair of retinal detachment, including drainage of subretinal fluid when performed; photocoagulation
CPT4 code
Name of the Procedure:
Repair of Retinal Detachment, including Drainage of Subretinal Fluid when performed; Photocoagulation
Summary
A repair of retinal detachment is a surgical procedure to reattach a retina that has pulled away from its normal position at the back of the eye. This may include the drainage of any fluid that has accumulated under the retina and may involve the use of laser photocoagulation to seal the retinal tears.
Purpose
This procedure addresses retinal detachment, a serious eye condition where the retina separates from the underlying layer of support tissue. The goal is to restore the retina to its correct position, re-establish normal vision, and prevent further vision loss.
Indications
- Sudden flashes of light
- Sudden appearance or increase of floaters
- A shadow or curtain over a part of the visual field
- Recent trauma or history of severe myopia which increases risk
Preparation
- Follow fasting instructions, usually no food or drink after midnight before the surgery.
- Arrange transportation home post-procedure due to temporary vision impairment.
- Stop blood-thinning medications if advised by the doctor.
- Undergo a pre-operative eye exam and other required diagnostic tests.
Procedure Description
- Anesthesia: Local anesthesia to numb the eye, sometimes combined with sedation.
- Procedure Steps:
- A small incision is made in the eye.
- Any subretinal fluid is carefully drained to flatten the retina.
- Photocoagulation via laser is applied to create a scar, sealing retinal tears and reattaching the retina to the back of the eye.
- Tools and Technology: Microsurgical instruments, laser photocoagulator.
- Closure: The incision is closed, and a gas or oil bubble may be placed inside the eye to keep the retina in place as it heals.
Duration
Typically 1 to 2 hours.
Setting
Hospital or outpatient surgical center.
Personnel
- Ophthalmologist (surgeon)
- Anesthesiologist
- Nursing staff
- Surgical techs
Risks and Complications
- Infection
- Bleeding
- Increased intraocular pressure
- Cataract formation
- Recurrence of retinal detachment
- Vision loss
Benefits
- Restoration of vision
- Prevention of permanent vision loss
- High success rate in reattaching the retina
Recovery
- Follow the doctor's instructions on positioning (often face-down) to keep the gas bubble in place.
- Avoid heavy lifting, rigorous activity, or flying until cleared by the doctor.
- Use prescribed eye drops to prevent infection and control inflammation.
- Expect follow-up visits to monitor healing.
- Visual recovery can vary, typically improving over weeks to months.
Alternatives
- Pneumatic retinopexy: Involves injecting a gas bubble without surgical incision.
- Scleral buckle: A band is placed around the eye to push the retina back into place.
- Pros and Cons: Pneumatic retinopexy is less invasive but less suitable for complex detachment. Scleral buckling is effective but involves more extended recovery.
Patient Experience
- During: Mild discomfort from anesthesia, no pain.
- After: Mild to moderate pain or discomfort managed with medication, temporary blurry vision, and restrictions on activities.
- Pain Management: Oral pain medications as prescribed, cold compresses for swelling.
By following this guide, patients can better understand the repair of retinal detachment procedure and what to expect throughout the surgical experience.