CPT® Code 0621T

Trabeculostomy ab interno by laser, designated by CPT® Code 0621T, is a specialized surgical procedure aimed at treating glaucoma, a condition that can lead to blindness if not managed effectively. The primary goal of this procedure is to reduce intraocular pressure (IOP), which is crucial in preventing the progression of glaucoma. This technique falls under the category of micro-invasive glaucoma surgery (MIGS), which is characterized by its minimal risk and high safety profile compared to traditional surgical methods. The ab interno approach involves creating a direct opening in the trabecular meshwork from within the anterior chamber of the eye, thereby enhancing the outflow of aqueous humor. This is achieved through the use of a laser to create multiple microchannels that connect to Schlemm’s canal and the collector channels, facilitating improved drainage of fluid from the eye. The procedure utilizes a fine probe, measuring 500 μm in diameter, and requires a small corneal incision of at least 0.8 mm. To maintain the integrity of the anterior chamber during the procedure, a viscoelastic substance is introduced. The use of a goniolens or an ophthalmic endoscope aids in the precise targeting of the trabecular meshwork. The application of laser energy results in the formation of approximately ten microchannels, strategically placed 500 μm apart over a 90-degree arc. This innovative technique not only addresses IOP reduction but is also believed to induce a pneumatic effect that further dilates Schlemm’s canal, enhancing the overall outflow of aqueous humor and contributing to the management of glaucoma.