CPT® Code 65767

1. Indications

The procedure of epikeratoplasty is indicated for specific conditions affecting the cornea. These include:

• Corneal Damage The procedure is performed to address areas of the cornea that have sustained damage, which may be due to trauma, disease, or other pathological conditions.
• Corneal Thinning Epikeratoplasty is indicated for patients with thinning of the cornea, which can compromise vision and the structural integrity of the eye.
• Corneal Defects The procedure is suitable for filling defects in the cornea, providing a means to restore the corneal surface and improve visual function.

2. Procedure

The epikeratoplasty procedure involves several critical steps to ensure successful grafting and healing.

• Step 1: Preparation of the Recipient Site The surgeon begins by carefully removing the corneal epithelium from the damaged or thinned area of the cornea. This step is essential to create a clean and suitable surface for the donor graft.
• Step 2: Graft Preparation Donor corneal tissue is then obtained, which has been previously reshaped and freeze-dried. This preparation is crucial as it ensures the graft is ready for implantation and can integrate effectively with the recipient's cornea.
• Step 3: Graft Placement The prepared donor corneal tissue is placed into the defect created by the removal of the corneal epithelium. This step requires precision to ensure proper alignment and coverage of the affected area.
• Step 4: Securing the Graft Once the graft is positioned correctly, it is secured in place using sutures. This stabilization is vital for the graft to remain in position during the initial healing phase.
• Step 5: Eyelid Suturing (if necessary) In some cases, the surgeon may choose to temporarily suture the eyelids closed. This technique helps to protect the graft and allows the patient's corneal tissue to grow over the graft surface, facilitating integration.

3. Post-Procedure

After the epikeratoplasty procedure, patients can expect a recovery period during which specific care is necessary. Typically, the corneal epithelium begins to heal within 4 to 5 days, at which point the eyelid sutures, if used, are removed. Patients are advised to continue using prescribed eye drops or ointments to support the healing process and protect the graft. Complete stabilization of the graft, achieved through the overgrowth of new corneal epithelium, usually takes about 2 to 3 months. During this time, regular follow-up appointments are essential to monitor the healing process and ensure that the graft is integrating properly with the recipient's cornea.