CPT® Code 67250

Scleral reinforcement is a surgical procedure aimed at addressing high myopia, a condition characterized by severe nearsightedness that can lead to complications such as damage to the macula. This procedure is performed as a separate intervention and is designed to prevent further deterioration of the eye's structure and function. During the operation, a lid speculum is utilized to hold the eyelids open, providing the surgeon with a clear view of the eye. Local anesthesia is administered to ensure patient comfort throughout the procedure. The surgical approach involves making an incision in the conjunctiva and Tenon's capsule, which are layers of tissue surrounding the eye, approximately 6 mm from the corneal limbus. The lateral, superior, and inferior recti muscles, which control eye movement, are carefully separated using a specialized instrument known as a strabismus hook. This allows access to the posterior pole of the eye, where connective tissue is meticulously dissected away from the inferior oblique muscle. In the context of CPT® Code 67250, the sclera is reinforced without the use of a graft. This process includes creating an indentation in the posterior aspect of the sclera, which is achieved by oversewing the weakened area with a thick piece of rubber or sponge material. This technique causes the posterior region of the sclera to indent or buckle, providing structural support. Additionally, a strip of synthetic material may be employed to create a sling that further supports the posterior sclera. This sling is positioned beneath the separated muscles along the posterior pole and is sutured to the anteromedial and anterolateral sclera, enhancing the stability of the eye's structure. This procedure is distinct from CPT® Code 67255, which involves the use of a graft for scleral reinforcement.