Name of the Procedure:

Injection, dexamethasone, intravitreal implant, 0.1 mg (HCPCS Code: J7312)

Summary

This procedure involves injecting a small implant containing dexamethasone, a steroid medication, directly into the eye. The implant slowly releases the medication over time to reduce inflammation and swelling in the retina.

Purpose

The primary purpose of this procedure is to treat various eye conditions that cause inflammation and swelling in the retina, such as diabetic macular edema, retinal vein occlusion, and uveitis. The goal is to enhance vision, reduce swelling, and prevent further ocular damage.

Indications

• Diabetic macular edema
• Retinal vein occlusion
• Uveitis (inflammation of the uvea)
• Other conditions resulting in retinal swelling and inflammation

Preparation

• The patient should inform the doctor about all medications they are taking.
• The patient might need to stop using certain blood-thinning medications.
• Diagnostic tests like eye examination or imaging tests (OCT) will be conducted to assess the retina.

Procedure Description

1. The procedure begins with the administration of a local anesthetic to numb the eye.
2. The eye is then cleaned with an antiseptic solution.
3. Using a fine needle, the physician carefully injects the dexamethasone implant into the vitreous cavity of the eye.

4. The implant gradually releases the medication over several months.

   Tools and Equipment:

   • Fine injection needle
   • Antiseptic solution
   • Anesthetic drops or injection

Anesthesia:

• Local anesthesia to numb the eye area

Duration

The procedure typically takes about 15-30 minutes.

Setting

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

Personnel

• Ophthalmologist or retinal specialist
• Nurses or medical assistants

Risks and Complications

Common Risks:

• Increased intraocular pressure
• Eye infection
• Temporary discomfort or redness

Rare Risks:

• Retinal detachment
• Cataract formation
• Severe infection (endophthalmitis)

Complications are managed by closely monitoring the patient’s condition and administering additional treatments as needed.

Benefits

• Reduction in retinal inflammation and swelling
• Improvement in vision
• Prevention of further ocular damage
• Benefits can usually be seen within a few weeks of the procedure

Recovery

• Patients may need to use prescribed eye drops to prevent infection and control inflammation.
• The eye should be protected from dirt and contaminants.
• Avoid vigorous activities and touching the eye.
• Follow-up appointments are necessary to monitor the eye’s response to the treatment and check for complications.

Expected recovery time:

• Patients can typically resume normal activities within a day or two but should adhere to specific post-procedure care instructions.

Alternatives

• Oral or systemic corticosteroids
• Anti-VEGF injections
• Laser therapy
• Each alternative has its own set of pros and cons in terms of efficacy, side effects, and patient convenience.

Patient Experience

During the procedure:

• Minimal discomfort due to local anesthesia
• Sensation of pressure when the injection is administered

Post-procedure:

• Mild irritation or redness in the eye
• Temporary blurriness as the eye adjusts
• Pain management typically involves over-the-counter medications and use of prescribed eye drops. Most patients find any discomfort to be temporary and manageable.