CPT® Code 66155

The procedure described by CPT® Code 66155 involves the surgical technique known as fistulization of the sclera, specifically aimed at treating glaucoma. This procedure utilizes thermocauterization in conjunction with an iridectomy, which is the surgical removal of a portion of the iris. The primary goal of this intervention is to facilitate the drainage of aqueous humor from the eye, thereby reducing intraocular pressure, which is critical in managing glaucoma. During the procedure, the eye is examined under an operating microscope to ensure precision and clarity. An incision is made in the conjunctiva, which is the thin membrane covering the white part of the eye, near the limbus—the border between the cornea and sclera. This incision allows access to the sclera, the tough outer layer of the eye. Once the sclera is exposed, a small opening is created in the pars plana, a region of the ciliary body, using a specialized instrument known as a Fugo blade. This device employs plasma energy to cut through tissue with minimal bleeding, as it simultaneously cauterizes the tissue while making the incision. The iridectomy involves creating a small hole in the iris, which is essential for allowing fluid to drain from the posterior chamber of the eye into the subconjunctival lymphatics. This drainage is crucial for lowering intraocular pressure, which, if left unmanaged, can lead to vision loss. After the necessary surgical steps are completed, the scleral incision is meticulously closed with sutures, followed by the closure of the conjunctiva to ensure proper healing and protection of the eye.