Name of the Procedure:

Fabrication and fitting of ocular conformer (HCPCS V2628)
Common name(s): Ocular conformer fitting
Technical or medical terms: Fabrication and fitting of ocular conformer

Summary

In simple terms, this procedure involves creating and fitting a custom-made device called an ocular conformer, which helps shape and support the eye socket following surgery, trauma, or other conditions. The device is tailored to fit the patient's specific anatomy.

Purpose

The ocular conformer helps maintain the eye socket's shape and symmetry, promoting healing and providing a foundation for future prosthetic eye placement. The expected outcome is to achieve a well-formed eye socket that can comfortably hold a prosthetic eye.

Indications

• Post-enucleation (removal of the eye)
• Post-evisceration (removal of the eye contents but leaving the sclera)
• Post-trauma with significant eye socket deformity
• Congenital eye abnormalities requiring socket molding

Preparation

• No specific fasting or dietary restrictions are generally required.
• Patients may need to stop certain medications, as directed by their doctor.
• A thorough eye and socket examination will be conducted.
• Imaging studies, like CT scans or MRIs, might be required to assess the socket's structure.

Procedure Description

1. Initial Assessment: The eye care specialist examines the eye socket.
2. Impression Taking: A mold of the eye socket is created using a special impression material.
3. Conformer Fabrication: The mold is used to fabricate a custom ocular conformer that fits the patient's socket precisely.
4. Fitting: The fabricated conformer is carefully fitted into the eye socket, adjustments are made for comfort and optimal fitting.
5. Instructions: Patients receive instructions on how to care for and clean the conformer.

Tools and Equipment: Impression material, specialized conformer fitting tools, customized ocular conformer
Anesthesia: Usually none, but topical anesthesia may be used if necessary.

Duration

The entire process typically takes a few hours, with the initial fitting appointment lasting around 1-2 hours.

Setting

This procedure is usually performed in an outpatient clinic specializing in ocular prosthetics or an eye care center.

Personnel

• Ocularist (specialist in eye prosthetics)
• Ophthalmologist (eye surgeon)
• Supportive nursing staff

Risks and Complications

• Minor discomfort or irritation
• Infection, which is rare and manageable with antibiotics
• Conformer displacement or poor fit, requiring adjustments
• Allergic reaction to materials used (rare)

Benefits

• Helps maintain the shape of the eye socket
• Promotes healing post-surgery or trauma
• Provides a foundation for future prosthetic eye placement Benefits are typically realized within a few weeks as the socket begins to heal.

Recovery

• Follow instructions for cleaning and care of the conformer.
• Attend regular follow-up appointments to monitor healing and fitting.
• Recovery time varies but generally involves a few weeks of healing, with some initial discomfort.

Alternatives

• Leaving the socket without a conformer, which may result in an irregular socket shape.
• Immediate placement of a prosthetic eye, though this is often less preferable shortly after surgery or trauma.

Patient Experience

• Patients might feel some initial discomfort or mild irritation.
• The process of impression and fitting is generally well-tolerated with minimal pain.
• Effective pain management and comfort measures are provided by the healthcare team, ensuring the patient's comfort during and after the procedure.