Name of the Procedure:

Trifocal seg width over 28 mm
Common Name: Trifocal intraocular lens fitting
Technical/Medical Term: Trifocal seg width over 28 millimeters (HCPCS Code: V2319)

Summary

The trifocal lens fitting is a procedure where trifocal lenses, which have three distinct optical zones for near, intermediate, and distance vision, are fitted to correct vision. These lenses may be specifically designed for widths over 28 millimeters to accommodate larger eye structures or specific vision correction needs.

Purpose

Trifocal lenses are designed to address age-related changes in vision such as presbyopia, which affects near vision focus. The goal is to provide clear vision at multiple distances without the need for multiple pairs of glasses.

Indications

• Symptoms of presbyopia
• Difficulty focusing on objects at varying distances
• Patients requiring vision correction for near, intermediate, and distance vision simultaneously
• Those who prefer not to alternate between multiple types of glasses

Preparation

• Comprehensive eye examination including a refraction test
• Measurement of the eye's focal lengths
• No specific fasting or medication adjustments are typically needed
• Discussion of the patient's vision needs and lifestyle habits

Procedure Description

1. Initial Consultation: Discuss vision issues, lifestyle, and the benefits of trifocal lenses.
2. Measurements: Conduct eye measurements to determine the correct lens size and curvature.
3. Lens Selection: Choose a trifocal lens with a segment width over 28 mm based on individual needs.
4. Lens Fitting:
   • Place the trifocal lenses on the patient's eyes
   • Adjust the lenses to ensure the segments align properly for optimal vision correction

5. Assessment: Evaluate vision at near, intermediate, and distance to ensure proper fitting and clarity.

   Tools, Equipment, Technology Used:

   • Auto-refractor and phoropter for measurements
   • Trial lens sets
   • Slit lamp microscope for detailed eye examination

Anesthesia/Sedation: None required for lens fitting.

Duration

The lens fitting procedure typically takes about 30-60 minutes, including measurements and fitting assessment.

Setting

• Optometrist or ophthalmologist's office
• Outpatient clinic

Personnel

• Optometrist or ophthalmologist
• Trained optometric technician or assistant

Risks and Complications

• Temporary discomfort or irritation
• Inaccurate lens positioning requiring re-adjustment
• Rare allergic reactions to lens material
• Initial adaptation period where vision might be slightly blurry or disorienting

Benefits

• Improved vision across multiple distances
• Reduced need for multiple pairs of glasses
• Enhanced lifestyle convenience and satisfaction
• Benefits can be realized immediately, but full adaptation may take a few weeks

Recovery

• Temporary adjustments may be needed to improve lens fit.
• Follow-up appointments to assess long-term vision correction.
• Patients can generally resume normal activities immediately after the fitting.

Alternatives

• Bifocal or multifocal lenses
• Monovision correction using contact lenses
• Progressive addition lenses (PALs) for glasses
• Pros of alternatives include different adaptation profiles; cons may include limited vision in intermediate zones or increased dependency on multiple glasses.

Patient Experience

• Minimal discomfort during and after the fitting process
• May experience a brief adaptation period where vision appears slightly blurry or disorienting
• Pain management is typically not needed; any discomfort usually subsides quickly
• Instruction on lens care and maintenance will be provided to ensure the longevity and cleanliness of the lenses.