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Cataract Extraction

1.Anatomy
2.Medical necessity of Procedure
3.Procedure detail
4.Code selection criteria
5.Important Terminology 

1.Anatomy

  1. Sclera: The sclera is the white, opaque, outer layer of the eye that provides structural support and protection​.

  2. Pupil: The pupil is the black, circular opening in the center of the iris (the colored part of the eye) that controls the amount of light entering the eye.

  3. Iris: Iris is the coloured part surrounding the pupil.The iris controls the size of the pupil by expanding or contracting it. The iris dilator muscle opens the pupil, while the iris sphincter muscle closes it.

  4. Conjuctiva: The conjunctiva is a thin, transparent membrane that covers the front surface of the eye (excluding the cornea) and lines the inside of the eyelids. It plays an important role in protecting the eye and maintaining its health.

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  1. Cornea: The cornea is the transparent, dome-shaped front part of the eye that covers the iris, pupil, and anterior chamber. It plays a crucial role in vision by refracting (bending) light that enters the eye and helping to focus it on the retina at the back of the eye.

  2. Choroid: The choroid is a layer of tissue in the eye that's made up of blood vessels and connective tissue: Location: The choroid is located between the retina and the sclera, or the white part of the eye.The choroid supplies oxygen and nutrients to the eye's inner parts.

  3. Lens: In the eye, the lens is a clear, curved structure at the front of the eye behind the pupil. It focuses light rays that enter the eye through the pupil, making an image on the retina.

  4. Retina: The retina is a light-sensitive layer of tissue at the back of the eye that converts images into electrical signals to send to the brain

  5. Aqueous humor vs posterior humor: The aqueous humor flows in and out of the front of your eye. Its job is to keep proper ocular pressure (eye pressure) in your eye. The pressure is maintained by having the same amount of fluid come in as the amount of fluid leaving the front of your eye.

      

      This fluid fills the anterior and posterior chambers of your eye.The vitreous humor provides nutrients         to your eye and helps your eye keep its shape. ​

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Extraocular muscles are a group of six muscles that control the movements of the eye and are essential for coordinating eye movement, allowing us to look in different directions. These muscles are attached to the outer surface of the eyeball and are responsible for the precise movements required for proper vision

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There are Six Extraocular Muscles:

  1. Medial Rectus Muscle

  2. Lateral Rectus Muscle

  3. Superior Rectus Muscle

  4. Inferior Rectus Muscle

  5. Superior Oblique Muscle

  6. Inferior Oblique Muscle

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2.Medical necessity of Procedure

A cataract is a cloudy area that develops in the lens of the eye, which can cause blurred or distorted vision

3.Procedure detail

Cataract extraction is a surgical procedure performed to remove a cataract, which is a clouding of the lens in the eye that leads to decreased vision.

4.Code selection criteria

Go to Catract- Extraction- Extracapsular/ Intracapsular, So code selection based on

  1. Simple or Complex extraction

  2. Extracapsular or Intracapsular

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Types of Cataract Extraction:

  • Phacoemulsification: This is the most common method of cataract surgery. During this procedure, the surgeon uses ultrasound waves to break up (emulsify) the cloudy lens into tiny fragments, which are then suctioned out through a small incision. After removing the cataract, an artificial intraocular lens (IOL) is often implanted to restore clear vision.

  • Extracapsular Cataract Extraction (ECCE): In this method, the surgeon makes a larger incision to remove the cloudy lens in one piece. This approach is less common today due to the advantages of phacoemulsification but may still be used in certain cases.

  • Intracapsular Cataract Extraction: This technique involves removing the entire lens along with the surrounding capsule. It is rarely performed today due to the advancements in phacoemulsification techniques.

5.Important Terminology

What is difference between Extracapsular cataract extraction and Intracapsular catarac extraction ?

In ICCE, the entire lens, including the surrounding capsule (which holds the lens in place), is removed in one piece. This requires a large incision.

In ECCE, only the cloudy lens is removed, while the posterior part of the lens capsule is left intact. This capsule acts as a support for the artificial intraocular lens (IOL) that is implanted during the surgery.

The surgeon makes a smaller incision compared to ICCE, removes the hard lens nucleus in one piece, and then the remaining lens matter is aspirated

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Watch video of this procedure : https://www.youtube.com/watch?v=DbusjeSdxJI

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