CPT® Code 0123T

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Fistulization of the sclera for glaucoma, specifically through the ciliary body, is a surgical procedure aimed at alleviating the symptoms of glaucoma, a condition marked by elevated intraocular pressure that can result in damage to the optic nerve and potential vision loss. This technique, known as transciliary fistulization or filtration, involves creating a controlled opening in the sclera, which is the white outer layer of the eyeball. The procedure begins with the formation of a flap in the conjunctiva, the thin membrane covering the front of the eye, to provide access to the sclera and the pars plana region of the ciliary body. Utilizing advanced technology, such as a thermo-cauterization device like a Fugo or plasma blade, the surgeon employs plasma energy to dissolve tissue bonds effectively. This process is critical for creating a micro-pore filter track that extends from the sclera into the ciliary body. The newly formed channel allows aqueous humor, the fluid within the eye, to drain from the posterior chamber into the subconjunctival lymphatic system. This drainage mechanism is essential for reducing intraocular pressure, thereby helping to manage the progression of glaucoma and preserving the patient's vision.