Name of the Procedure:

Injection, ocriplasmin, 0.125 mg (HCPCS J7316)

Summary

This procedure involves the injection of ocriplasmin, a medication used to treat certain eye conditions. The injection is administered directly into the eye to help resolve issues affecting the vitreous, the clear gel that fills the space between the lens and the retina.

Purpose

Medical Conditions:

• Symptomatic Vitreomacular Adhesion (VMA)
• Vitreomacular Traction (VMT)

Goals:

• To reduce or eliminate the adhesion between the vitreous and the macula
• To improve vision by resolving traction that distorts or blurs central vision

Indications

• Patients with symptomatic VMA or VMT
• Presence of certain retinal conditions that make the procedure appropriate, as determined by an ophthalmologist

Preparation

• A thorough eye examination and diagnostic imaging (e.g., Optical Coherence Tomography or OCT)
• Patients might need to avoid certain medications
• No specific fasting requirements, but patients should follow their doctor's instructions

Procedure Description

1. Preparation: The eye is numbed with anesthetic drops.
2. Disinfection: The eye area is cleaned to prevent infection.
3. Injection: Ocriplasmin is injected into the eye's vitreous cavity using a fine needle.
4. Post-Injection: The patient is observed for a short period to ensure there are no immediate complications.

Tools/Equipment:

• Fine injection needle
• Anesthetic eye drops
• Disinfection solutions

Anesthesia:

• Local anesthesia with eye drops

Duration

The injection procedure typically takes about 10-15 minutes.

Setting

The procedure is usually performed in an outpatient setting such as an eye clinic or a specialized surgical center.

Personnel

• Ophthalmologist (eye surgeon)
• Ophthalmic nurse or assistant

Risks and Complications

Common Risks:

• Eye pain or discomfort
• Blurred vision
• Temporary increase in eye pressure

Rare Risks:

• Retinal detachment
• Severe infection (endophthalmitis)
• Significant vision loss

Benefits

• Improvement in vision quality
• Possible resolution of VMA or VMT without the need for more invasive surgery
• Results may be noticed within days to weeks post-injection

Recovery

• Patients may experience mild discomfort and blurred vision for the first few days
• Use of prescribed eye drops to prevent infection or reduce inflammation
• Regular follow-up appointments to monitor progress
• Normal activities can often be resumed within a few days

Alternatives

• Vitrectomy: A more invasive surgical option to remove the vitreous gel and address VMA or VMT
  • Pros: Directly addresses the problem, often with immediate results
  • Cons: Higher risk, longer recovery time, more invasive
• Observation: Monitoring the condition without immediate intervention
  • Pros: Non-invasive, no immediate risks or recovery time
  • Cons: Potential progression of the condition, possible worsening of symptoms

Patient Experience

During the procedure, patients might feel:

• Mild pressure from the numbing drops
• A slight pinch from the injection (often not painful due to anesthesia)

After the procedure, patients may experience:

• Mild discomfort and blurred vision
• Instructions for how to use prescribed eye drops

• Measures to reduce any discomfort, such as over-the-counter pain relief if needed

  Pain is generally mild and easily manageable.