CPT® Code 67255

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 involves the use of a graft to provide additional support to the weakened sclera, which is the white outer layer of the eyeball. The procedure begins with the application of local anesthesia to ensure patient comfort. A lid speculum is utilized to hold the eyelids open, allowing the surgeon to access the eye. The conjunctiva, a thin membrane covering the eye, along with Tenon's capsule, is incised approximately 6 mm from the corneal limbus, which is the border between the cornea and the sclera. The lateral, superior, and inferior recti muscles, which control eye movement, are carefully separated using a strabismus hook to facilitate access to the posterior aspect of the sclera. In cases where the sclera is reinforced without a graft, as described in CPT® Code 67250, the procedure involves creating an indentation in the posterior sclera. However, in CPT® Code 67255, a graft is employed to bolster the weakened area. The thinned region of the sclera is oversewn with a graft, typically an allograft from a donor, which is sutured to the healthier anterior sclera. This reinforcement helps to prevent further damage to the eye and supports the structural integrity of the sclera. After the graft is secured, the separated muscles are repaired, and the conjunctiva and Tenon's capsule are closed, completing the procedure.