67208 Destruction of localized lesion of retina (eg, macular edema, tumors), 1 or more sessions; cryotherapy, diathermy

Name of the Procedure:

Destruction of Localized Lesion of Retina (e.g., Macular Edema, Tumors) by Cryotherapy, Diathermy

Summary

This procedure targets and destroys abnormal growths or lesions on the retina, such as those seen in macular edema or eye tumors, using techniques like cryotherapy (freezing the tissue) or diathermy (using electric currents to generate heat). It may involve one or more treatment sessions.

Purpose

The procedure aims to remove or shrink retinal lesions to prevent vision loss, reduce swelling, and improve visual function. It addresses conditions like macular edema and retinal tumors.

Indications

• Macular edema (swelling of the central retina)
• Retinal tumors
• Other localized retinal lesions
• Symptoms include blurry vision, dark spots, and vision distortion

Patient criteria: presence of retinal lesions identifiable through diagnostic imaging and ineffective response to other treatments.

Preparation

• Fasting may not be required but follow specific instructions provided by your doctor.
• Adjustments in medications as advised.
• Pre-procedure eye exams and imaging (e.g., optical coherence tomography, fluorescein angiography).

Procedure Description

1. The patient is positioned comfortably, and a numbing eye drop is applied.
2. For cryotherapy:
   • A cryoprobe is applied to the sclera (white of the eye), freezing the lesion.
3. For diathermy:
   • A diathermy needle is inserted and electric currents are used to heat and destroy the lesion.
4. The entire process is monitored using imaging tools.

Local anesthesia or mild sedation may be used to ensure comfort.

Duration

The procedure typically lasts between 30 minutes to an hour.

Setting

Usually performed in an outpatient clinic, hospital, or surgical center equipped with specialized ophthalmic facilities.

Personnel

• Ophthalmologist (retinal specialist)
• Nurses
• Technicians
• Anesthesiologist (if sedation is required)

Risks and Complications

• Common risks: mild discomfort, temporary vision changes, swelling, infection.

• Rare risks: significant vision loss, retinal detachment, bleeding, excessive scarring.

  Management involves medications, additional procedures, or vision aids as required.

Benefits

• Reduction or elimination of retinal lesions.
• Improved or stabilized vision.
• Relief from symptoms like blurriness and vision obstruction.

Benefits are often realized within a few weeks post-treatment.

Recovery

• Use prescribed eye drops to reduce swelling and prevent infection.
• Avoid strenuous activities for a few days.
• Follow-up appointments to monitor healing.
• Gradual return to normal activities in about a week.

Alternatives

• Laser photocoagulation: uses a laser to create burns on the retina to shrink lesions.
• Anti-VEGF injections for macular edema.
• Surgical removal for certain types of tumors.

Pros and cons:

• Laser photocoagulation: lower risk of infection but may require multiple sessions.
• Anti-VEGF injections: effective for swelling but involves repeated treatments.
• Surgery: direct removal but higher risk and longer recovery.

Patient Experience

During the procedure, expect feelings of pressure and mild discomfort from the numbing drops. Post-procedure, slight pain and blurry vision might occur, managed with pain relievers and rest. Follow medical advice to ensure a smooth recovery.