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Prophylaxis of retinal detachment (eg, retinal break, lattice degeneration) without drainage, 1 or more sessions; cryotherapy, diathermy

CPT4 code

Name of the Procedure:

Prophylaxis of Retinal Detachment (e.g., Retinal Break, Lattice Degeneration) Without Drainage, 1 or More Sessions; Cryotherapy, Diathermy

Summary

This procedure involves the use of cryotherapy (freezing therapy) or diathermy (heat therapy) to treat and prevent retinal detachment, which can occur due to retinal breaks or lattice degeneration. The procedure is done without draining any retinal fluid.

Purpose

This procedure is designed to address retinal breaks and lattice degeneration to prevent retinal detachment. By creating a scar that seals the retinal tear or secures areas of thinning, it helps stabilize the retina and prevent further deterioration or vision loss.

Indications

  • Presence of retinal breaks or tears identified during an eye exam.
  • Lattice degeneration detected via retinal imaging.
  • Symptoms like flashes of light, floaters, or a shadow over the visual field.
  • High-risk factors such as a history of retinal detachment, severe myopia, or family history of retinal problems.

Preparation

  • Patients may need a comprehensive eye exam and retinal imaging prior to the procedure.
  • Fasting is not typically required.
  • Patients should inform their doctor of any medications they are taking, particularly blood thinners.
  • Potentially dilating eye drops may be used before the procedure to allow the eye specialist a better view of the retina.

Procedure Description

  1. The eye will be numbed with local anesthesia or numbing eye drops.
  2. The ophthalmologist uses a specialized probe for cryotherapy or an electrodiathermy device to apply controlled freezing or heating to the affected area of the retina.
  3. The thermal energy creates a scar that will help seal any retinal breaks or strengthen areas of lattice degeneration.
  4. The procedure may take place in one or multiple sessions based on the severity and response of the initial treatment.

Duration

The procedure typically takes about 30 minutes to an hour.

Setting

This procedure is often performed in an outpatient clinic or an eye specialist's office.

Personnel

  • Ophthalmologist or retinal specialist
  • Assisting nurse or technician

Risks and Complications

  • Temporary pain or discomfort during the procedure.
  • Swelling or bruising around the eye.
  • Infection (rare but possible).
  • Double vision or changes in vision.
  • Potential need for additional treatments if the initial session is insufficient.

Benefits

  • Prevention of retinal detachment and associated vision loss.
  • Stabilization of retinal structure and function.
  • Rapid recovery with most patients resuming normal activities shortly after.

Recovery

  • Patients might experience mild discomfort or soreness which can be managed with over-the-counter pain relief.
  • Avoid strenuous activities and heavy lifting for at least a few days.
  • Follow-up appointments for monitoring and additional treatment if necessary.
  • Use prescribed eye drops to prevent infection and inflammation.

Alternatives

  • Laser photocoagulation to treat retinal tears and degeneration.
  • Surgical interventions like scleral buckle or vitrectomy in more advanced cases.
  • Each alternative has its own risk and benefit profile, often considered depending on the specific retinal condition and patient health.

Patient Experience

  • During the procedure, patients might feel pressure or mild discomfort but should not feel pain due to the anesthesia.
  • Post-procedure, vision may be blurry, and mild irritation or redness may be present.
  • Pain management can include prescribed medications if needed, but many manage well with simple over-the-counter solutions.

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