CPT® Code 66700

1. Indications

The procedure described by CPT® Code 66700 is indicated for the treatment of glaucoma, particularly in cases where the condition has not adequately responded to medication or other conservative surgical interventions. The primary goal of this procedure is to manage intraocular pressure effectively, which is crucial for preventing further damage to the optic nerve and preserving vision.

• Glaucoma The procedure is performed when glaucoma has failed to respond to medication and other less invasive surgical treatments.

2. Procedure

The procedure begins with the administration of a local periocular anesthetic to ensure patient comfort during the intervention. Following anesthesia, a lid speculum is placed on the eye to keep the eyelids open, providing the surgeon with unobstructed access to the eye. The surgeon then selects the appropriate approach for the diathermy procedure, which can be either an extra-ocular transcleral or transconjunctival approach. In some instances, a scleral flap may be elevated to gain direct access to the ciliary body. Once access is achieved, a heat probe is utilized to destroy the ciliary body tissue. This destruction effectively reduces the production of aqueous humor, leading to a decrease in intraocular pressure, which is essential for managing glaucoma.

• Step 1: Administer a local periocular anesthetic to ensure patient comfort during the procedure.
• Step 2: Place a lid speculum on the eye to hold the eyelids open, allowing for clear access to the surgical site.
• Step 3: Choose the appropriate approach for diathermy, either an extra-ocular transcleral or transconjunctival approach, or elevate a scleral flap if necessary.
• Step 4: Use a heat probe to destroy the ciliary body tissue, thereby reducing the inflow of aqueous humor and lowering intraocular pressure.

3. Post-Procedure

After the procedure, patients may be monitored for any immediate complications or adverse reactions to the anesthesia. Post-operative care typically includes instructions for managing discomfort, potential swelling, and the use of prescribed eye drops to prevent infection and reduce inflammation. Patients are advised to follow up with their ophthalmologist to assess the effectiveness of the procedure in lowering intraocular pressure and to monitor for any long-term effects on vision and eye health.