CPT® Code 66987

Extracapsular cataract removal with insertion of intraocular lens prosthesis (1-stage procedure), manual or mechanical technique (eg, irrigation and aspiration or phacoemulsification), complex, requiring devices or techniques not generally used in routine cataract surgery (eg, iris expansion device, suture support for intraocular lens, or primary posterior capsulorrhexis) or performed on patients in the amblyogenic developmental stage; with endoscopic cyclophotocoagulation

Complex extracapsular cataract removal with insertion of an intraocular lens (IOL) prosthesis is a specialized surgical procedure designed to address cataracts that present unique challenges. This one-stage procedure employs either manual or mechanical techniques, such as irrigation and aspiration or phacoemulsification, to effectively remove the cataract. The complexity of this surgery arises from the use of advanced devices or techniques that are not typically utilized in standard cataract surgeries. Such complexities may include the use of an iris expansion device, suture support for the IOL, or primary posterior capsulorrhexis, particularly in pediatric patients who are in the amblyogenic developmental stage. The procedure is particularly critical for children, as the anatomical and developmental characteristics of their eyes necessitate specific surgical approaches. For instance, the anterior capsule in children is more challenging to open, and the cortex is more difficult to remove due to lens adhesion. Additionally, certain ocular conditions, such as uveitis, glaucoma, pseudoexfoliation syndrome, or Marfan syndrome, can further complicate the surgery, necessitating a more intricate approach. Patients with a history of prior intraocular surgery, trauma to the eye, or those presenting with dense, hard, white cataracts may also require this complex procedure to ensure successful outcomes. The incorporation of endoscopic cyclophotocoagulation (ECP) during the surgery is particularly beneficial for glaucoma patients, as it can reduce the need for postoperative medication by treating the ciliary processes effectively.