CPT® Code 0661T

1. Indications

The removal and reimplantation of the anterior segment intraocular nonbiodegradable drug-eluting implant is indicated for patients requiring sustained intraocular pressure management due to glaucoma or other ocular conditions that necessitate targeted drug delivery. This procedure is particularly beneficial for individuals who may struggle with adherence to traditional eye drop regimens, as the implant provides a continuous release of medication directly into the anterior chamber.

• Glaucoma Management Patients diagnosed with glaucoma who require effective and consistent intraocular pressure reduction.
• Ocular Conditions Individuals with other ocular diseases that can benefit from localized drug delivery to the anterior segment of the eye.

2. Procedure

The procedure for the removal and reimplantation of the drug-eluting implant involves several key steps that ensure the effective management of intraocular pressure. Initially, a 2.4 mm incision is made in the eye to access the anterior chamber. This incision is strategically placed to facilitate an ab interno approach, allowing the surgeon to visualize the anterior chamber angle. Once access is obtained, the scleral anchor of the titanium implant is carefully positioned within the trabecular meshwork. The surgeon secures the anchor by gently nudging it into place, ensuring a stable attachment that will allow for effective drug delivery. After the implant has been properly seated, the next step involves the removal of the depleted titanium implant. This is performed using a similar micro-invasive technique, ensuring minimal trauma to the surrounding ocular structures. Following the removal, a new drug-eluting implant is then inserted into the same location, allowing for the continuation of therapy. This reimplantation process is crucial for maintaining the therapeutic effects of the medication and managing intraocular pressure effectively.

• Step 1: A 2.4 mm incision is made in the eye to access the anterior chamber.
• Step 2: The anterior chamber angle is visualized via an ab interno approach.
• Step 3: The scleral anchor is positioned in the trabecular meshwork and secured by nudging.
• Step 4: The depleted titanium implant is removed using a micro-invasive technique.
• Step 5: A new drug-eluting implant is inserted to continue therapy.

3. Post-Procedure

After the removal and reimplantation of the drug-eluting implant, patients may experience a recovery period that typically involves monitoring for any signs of complications, such as infection or inflammation. It is essential for healthcare providers to provide appropriate post-operative care instructions, which may include the use of topical medications to reduce inflammation and prevent infection. Patients should be advised to attend follow-up appointments to assess the effectiveness of the implant and monitor intraocular pressure. The expected recovery time may vary depending on individual patient factors, but most patients can resume normal activities within a short period following the procedure. Continuous evaluation of intraocular pressure will be necessary to ensure the ongoing effectiveness of the treatment.