CPT® Code 0617T

Deleted

Insertion of iris prosthesis, including suture fixation and repair or removal of iris, when performed; with removal of crystalline lens and insertion of intraocular lens

The procedure described by CPT® Code 0617T involves the insertion of an iris prosthesis, which is a specialized silicone disc designed to address issues related to a defective, missing, or damaged iris. This condition may arise from various causes, including acquired defects, trauma, congenital aniridia, or albinism. The iris prosthesis is custom-made for each patient, featuring a colorized design that includes a fixed diameter pupil, allowing it to closely match the appearance of the patient's other eye. The back of the prosthesis is designed with a black surface that effectively blocks light, permitting it to pass only through the pupil, thereby mimicking the natural function of the iris. During the surgical procedure, the outer diameter of the iris prosthesis is tailored to fit the patient using a trephine, ensuring a precise fit. The prosthesis can be implanted into the capsular bag or the ciliary sulcus through a sclerocorneal approach, or it may be inserted via an 'open sky' approach during a concurrent penetrating keratoplasty. The insertion of the disc is performed by folding it and using forceps or an autoinjector for placement. Depending on the individual patient's anatomy and specific surgical requirements, the prosthesis may be secured with suture fixation. In cases where progressive zonulopathy leads to displacement, sutures may be applied later to ensure proper positioning. It is important to note that the placement of the artificial iris should ideally occur simultaneously with the insertion of an intraocular lens (IOL) for patients undergoing cataract surgery. This approach is crucial to prevent any deterioration in vision quality, particularly glare sensitivity, which may occur if the cataract is treated separately before addressing the iris defect. For coding purposes, CPT® Code 0616T is used for the insertion of the iris prosthesis alone, while CPT® Code 0617T is applicable when the procedure includes the removal of the crystalline lens and the insertion of an IOL for cataract patients. Additionally, CPT® Code 0618T is designated for cases involving prosthetic iris insertion with a secondary IOL placement or lens exchange.