CPT® Code 67043

Vitrectomy, mechanical, pars plana approach; with removal of subretinal membrane (eg, choroidal neovascularization), includes, if performed, intraocular tamponade (ie, air, gas or silicone oil) and laser photocoagulation

A mechanical vitrectomy with removal of the subretinal membrane is a surgical procedure performed to treat choroidal neovascularization (CNV) using a pars plana approach. The vitreous is a gel-like substance that occupies the central cavity of the eye, and its removal is a critical step in addressing CNV, which involves the abnormal growth of new blood vessels in the choroid layer beneath the retina. This condition often arises due to a disruption in Bruch's membrane, the structural layer that separates the choroidal vascular layer from the retina. When this membrane is compromised, it can lead to the leakage of fluid or blood from the newly formed vessels, resulting in distorted vision and potential scarring of the macula, which is essential for sharp central vision. CNV can be caused by various factors, but it is most frequently seen in patients suffering from proliferative diabetic vitreoretinopathy, where traction forces can lead to retinal detachment or giant retinal tears. Given that CNV is a significant contributor to visual impairment, the procedure aims to restore vision by removing the problematic membrane and addressing any associated complications. The surgical technique involves making three small incisions in the pars plana region of the eye, allowing for the insertion of specialized instruments to illuminate the interior of the eye, remove the vitreous gel, and access the subretinal space for membrane removal. This comprehensive approach may also include the application of an intraocular tamponade, such as air, gas, or silicone oil, to stabilize the retina and prevent further complications.