Name of the Procedure:

Injection, bimatoprost, intracameral implant, 1 microgram (HCPCS J7351)

• Common Name(s): Bimatoprost Implant Injection
• Medical Term: Intracameral Bimatoprost Implantation

Summary

This procedure involves the injection of a small implant containing the medication bimatoprost into the eye. The implant is designed to release the drug gradually over time, helping to manage intraocular pressure (IOP) in patients with glaucoma or ocular hypertension.

Purpose

• Medical Conditions Addressed: Glaucoma, Ocular Hypertension
• Goals/Outcomes: The primary goal is to lower and manage elevated IOP to prevent damage to the optic nerve and loss of vision.

Indications

• Symptoms/Conditions: Elevated intraocular pressure, diagnosed glaucoma, ocular hypertension
• Patient Criteria: Patients who have not responded adequately to topical IOP-lowering medications or who have difficulty adhering to daily eye drop regimens.

Preparation

• Pre-procedure Instructions: Patients may be asked to stop certain medications or adjust dosages. They should have someone to drive them home after the procedure.
• Diagnostic Tests: Comprehensive eye examination including measurement of IOP, visual field test, and assessment of optic nerve health.

Procedure Description

1. Anesthesia: Local anesthetic drops are applied to numb the eye.
2. Implantation: A tiny, drug-eluting implant filled with bimatoprost is injected into the anterior chamber of the eye using a special applicator.
3. Post-Injection: The implant gradually releases bimatoprost to help reduce IOP over several months.

Duration

The procedure typically takes about 15-30 minutes.

Setting

Performed in a hospital, outpatient eye clinic, or a specialized surgical center.

Personnel

• Ophthalmologist (Eye Surgeon)
• Assisting Nurse or Technician
• Anesthesiologist (if sedation is required)

Risks and Complications

• Common Risks: Mild eye discomfort, temporary blurred vision, redness
• Rare Risks: Infection, increase in IOP, implant displacement, inflammation, and in rare cases, cataract formation
• Management: Follow-up visits to monitor complications and manage any adverse effects promptly.

Benefits

• Expected Benefits: Significant reduction in IOP, reduced need for daily eye drops, improved adherence to therapy
• Onset of Benefits: Benefits are usually seen within a few weeks and can last for several months to a year or more.

Recovery

• Post-procedure Care: Patients may need to use anti-inflammatory eye drops for a short period and avoid rubbing the eye.
• Recovery Time: Most can resume normal activities within a day or two but should avoid strenuous activities as advised by the physician.
• Follow-up: Regular follow-up appointments to monitor IOP and implant status.

Alternatives

• Other Treatments: Topical eye drops, oral medications, laser therapy, surgical options like trabeculectomy or shunt placement
• Pros and Cons: Eye drops require daily adherence; oral medications can have systemic side effects; laser and surgical treatments are more invasive and permanent but may offer more significant IOP reduction.

Patient Experience

• During Procedure: Minimal discomfort due to local anesthesia; a brief sensation of pressure may be felt.
• After Procedure: Mild discomfort or blurred vision initially; patients are usually comfortable with mild analgesics if needed. Vision typically stabilizes shortly after the procedure.