CPT® Code 0618T

Deleted

Insertion of iris prosthesis, including suture fixation and repair or removal of iris, when performed; with secondary intraocular lens placement or intraocular lens exchange

The procedure described by CPT® Code 0618T 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 to match the appearance of the other eye. The back of the prosthesis is designed with a black surface that effectively blocks light, allowing 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 adjusted to fit the patient's eye using a trephine, ensuring a precise fit. The insertion can be performed through different approaches, including the capsular bag, the ciliary sulcus via a sclerocorneal approach, or through an 'open sky' technique during a concurrent penetrating keratoplasty. The disc is typically folded and inserted into the eye using forceps or an autoinjector, and in some cases, suture fixation may be employed based on the patient's anatomical considerations and surgical requirements. It is important to note that the placement of the artificial iris should ideally occur simultaneously with the insertion of a secondary intraocular lens (IOL) for patients undergoing cataract surgery. This approach helps to prevent potential complications such as worsening vision and glare sensitivity that may arise if the cataract is treated separately before addressing the iris defect. For coding purposes, CPT® Code 0618T is specifically used when the iris prosthesis is inserted alongside a secondary IOL placement or lens exchange, distinguishing it from other related procedures that may involve the insertion of an iris prosthesis alone or in conjunction with the removal of the crystalline lens.