Physicians will have to make practice decisions based on best clinical judgment until controlled trials are conducted and their findings published. 2000;26(10):1435-1437. A meta-analysis by Takakura et al (2010) found no clear evidence of near visual acuity improvement with accommodating IOLs compared to monofocal IOLs. The indications were hyper-mature senile cataract in 9 cases, hyper-mature senile cataract with lens induced glaucoma in 9 cases, pseudo-exfoliation syndrome in 9 cases, post-blunt injury traumatic cataract in 6 cases, iridochoroidal coloboma in 6 cases, hyper-mature cataract with pseudo-exfoliation and Marfan syndrome in 3 cases, respectively. Zhang ML, Hirunyachote P, Jampel H. Combined surgery versus cataract surgery alone for eyes with cataract and glaucoma. 2009;(2):CD007293. They last searched the electronic databases on June 13, 2016. They used standard methodological procedures expected by The Cochrane Collaboration. Outpatient Ophthalmic Surgery Society, Society for Excellence in Eye Care, Society for Geriatric Ophthalmology, and the Ophthalmic Anesthesia Society. list-style-type: upper-roman; Second, several studies in this meta-analysis did not report sufficient data on risk assessment, especially random sequence generation, allocation concealment and setting blinding, which may have led to bias. Links to various non-Aetna sites are provided for your convenience only. Cochrane Database Syst Rev. In the group with historical data (n = 20), 35 % to 70 % of eyes were within 0.25 D, 60 % to 85 % of eyes were within 0.50 D, 80 % to 95 % of eyes were within 0.75 D, and 90 % to 95 % of eyes were within 1.00 D of targeted refractive IOL power prediction error. No difference was found for spectacle independence, posterior capsular opacification (PCO) incidence and patient satisfaction between bifocal IOLs and trifocal IOLs (RR = 0.89, 95 % CI: 0.71 to 1.12 for spectacle independence; RR = 1.81, 95 % CI: 0.50 to 6.54 for PCO incidence; RR = 0.98, 5 % CI: 0.86 to 1.12) for patient satisfaction. Monofocal IOLs have a fixed focal length and provide clear vision at a single, distance (near, intermediate or far) only. Interventional Procedure Guidance 264. For example, eye examinations performed to determine the refractive state of the eyes following insertion of a presbyopia-correcting IOL are non-covered (McClellan, 2005). This was a retrospective, cases-series study; its findings need to be validated by well-designed studies. Cochrane Database Syst Rev. Implantation of accommodating intraocular lenses for cataract. Accommodating intraocular lenses. Outcomes and costs of outpatient and inpatient cataract surgery: A randomised clinical trial. Fedorowicz Z, Lawrence D, Gutierrez P, van Zuuren EJ. Policy statement on cataract surgery in the otherwise healthy adult second eye. Indian J Ophthalmol. Posterior capsular opacification in 1 eye (2.4 %), anterior capsule phimosis in 1 eye (2.4 %) and cystoid macular edema (CME) in 1 eye (2.4 %) were detected as late complications. The capsules of the femtosecond group (0.95 0.02) were significantly more circular than the ones of the manual group (0.81 0.07; p < 0.0001). Celik et al (2015) reviewed the indications, clinical outcomes and complications of CTR implantation in a series of consecutive phacoemulsification surgeries during a 3-year period. San Francisco, CA: American Academy of Ophthalmology; 1991. CMS Rulings. cursor: pointer; American Academy of Ophthalmology. Trifocal intraocular lenses versus bifocal intraocular lenses after cataract extraction among participants with presbyopia. Slit-lamp examination provides more details about the character, location, and extent of the opacity. The electronic databases were last searched on April 16, 2012. Most cases relied on the Holladay 1 formula, with some preference to SRK/T for eyes with longer axial length, and Hoffer Q for eyes with shorter axial length. Paris, France: ANAES; 2000. Corneal topography is not routinely indicated prior to cataract removal surgery; it may be useful when irregular astigmatism is suspected of contributing to visual impairment (American Academy of Ophthalmology [AAO], 2001). padding-right: 18px; Cataract in the adult eye PPP 2016. The authors concluded that in this case-series study, there was a clear learning curve associated with the use of FLACS. margin-top: 38px; Clinical Policy Bulletins are developed by Aetna to assist in administering plan benefits and constitute neither offers of coverage nor medical advice. Posterior capsule opacification is a common complication after cataract surgery. Curr Opin Ophthalmol. 2018;1:CD006366. Landmarks in the evolution of cataract surgery. } WebCataract Surgery and Medicare Coverage Uncovered The short answer: Yes. However, due to small sample sizes and heterogeneity in outcome reporting, the authors found insufficient information to assess these and other types of IOL materials for cataract surgery for eyes with uveitis. The effect of combined surgery versus cataract surgery alone on the need for re-operation to control IOP at 1 year was uncertain (RR 1.13, 95 % CI: 0.15 to 8.25; 382 eyes). Aetna considers the following procedures medically necessary as a diagnostic test prior to cataract surgery: In addition to a comprehensive or brief/intermediate eye examination, A-mode ultrasound (A-scan) may be considered medically necessary prior to cataract surgery to determine the appropriate pseudophakic power of the IOL.Footnote1*. Guay J, Sales K. Sub-Tenon's anaesthesia versus topical anaesthesia for cataract surgery. Centers Near You Enter A New Address Procedures Custom LASIK Cataract Surgery Other Procedures This was combined with approximate costs in a cost-utility analysis model to determine the incremental cost-effectiveness ratios (ICERs). }. 2011;152(3):345-357. A total of 50 adult human eyes with visually significant cataract and regular corneal astigmatism of greater than or equal to 1.5D were divided into 2 groups of 25 eyes each, A and B by simple randomization. --> The IOL power was estimated pre-operatively using the IOLMaster 500 (Carl Zeiss Meditec, Dublin, CA) to calculate the Haigis-L and Masket regression formulae (when prior data were available), and the Optovue RTVue (Optovue Inc., Fremont, CA) spectral domain OCT was used to obtain the Fourier-domain OCT-based IOL formula. Medicare proposal to restrict medical necessity for cataract surgery. Stodola E. An update on billing policy for femtosecond laser use. Note: The use of capsular tension rings is considered integral to the ocular surgery and is not separately reimbursed. J Cataract Refract Surg. For near distances, patients with the Tecnis Symfony IOL were able to read two additional, progressively smaller lines on a standard eye chart than those with the monofocal IOL. J Cataract Refract Surg. Risks of bias, heterogeneity of outcome measures and study designs used, and the dominance of one design of accommodative lens in existing trials (the HumanOptics 1CU) mean that these results should be interpreted with caution. Extracapsular cataract surgery, retinal detachment, and YAG laser posterior capsulotomy. They searched CENTRAL (which contains the Cochrane Eyes and Vision Group Trials Register) (The Cochrane Library 2013, Issue 7), Ovid MEDLINE, Ovid MEDLINE In-Process and Other Non-Indexed Citations, Ovid MEDLINE Daily, Ovid OLDMEDLINE (January 1946 to August 2013), EMBASE (January 1980 to August 2013), Latin American and Caribbean Literature on Health Sciences (LILACS) (January 1982 to August 2013), the metaRegister of Controlled Trials (mRCT), ClinicalTrials.gov and the WHO International Clinical Trials Registry Platform (ICTRP). 1995;21(4):457-460. Main outcome measures included intra-operative complication rates and comparison between groups. American College of Eye Surgeons. They searched CENTRAL (which contains the Cochrane Eyes and Vision Trials Register) (2016, Issue 5), Ovid Medline, Ovid Medline In-Process and other non-indexed citations, Ovid Medline Daily, Ovid OldMedline (January 1946 to June 2016), Embase (January 1980 to June 2016), the ISRCTN registry, ClinicalTrials.gov, and the WHO International Clinical Trials Registry Platform (ICTRP). N Engl J Med. Results for the study were not yet available, but may be eligible for future updates of this review. Therefore, it is important that you check the details of the insurance policy before 2013;120(5):942-948. Leung and colleagues (2014) noted that cataract formation often occurs in people with uveitis. There was substantial heterogeneity with respect to the ages of participants and etiologies of uveitis within and across studies. Curr Opin Ophthalmol. The authors concluded that laser cataract surgery, irrespective of potential improvements in VA outcomes and complication rates, was not cost-effective at its current cost to patient when compared with cost-effectiveness benchmarks and other medical interventions, including PCS. color: white; However, these cases comprised a small portion of this study, and the IOL powers provided by ORA were also chosen with the patients' post-operative goals in mind . Analysis on AT LISA subgroup indicated the bifocal group had worse intermediate VA than trifocal group (AT LISA tri 839 M) (MD = 0.18, 95 % CI: 0.12 to 0.24 for UIVA and MD = 0.19, 95 %CI: 0.13 to 0.25 for DCIVA). Eur J Ophthalmol. Yes, cataract surgery is covered by health insurance. The Alcon AcrySof Natural UV and blue light filtering acrylic foldable multi-piece posterior chamber lenses are optical implants for the replacement of the human crystalline lens in the visual correction of aphakia in adult patients following cataract surgery. This testing, however, may be useful for corroborating glare symptoms in a small percentage of cataract patients who complain of glare, yet measure good Snellen visual acuity. The difference in occurrence of endophthalmitis with/without topical antibiotics in each group (ICC: 0.016 % and 0.017 %; p = 0.958; ICM: 0.040 % and 0.058 %; p = 0.538) was not significant (p = 0.376). The mean age of patients included was 69.2 9.8 years. Since cataracts The member's best correctable Snellen visual acuity is 20/40 Snellen or better in the affected eye, There is a significant loss of visual acuity in bright ambient light thatisconfirmed bythe use of (but not limited to) procedures such as glare testing, brightness acuity testing (BAT), or contrast sensitivity testing, or, Complaints of monocular diplopia or polyopia, or, Visual disparity existing between the two eyes (anisometropia),and. The alternative lens was then implanted in the second eye 4 to 6 weeks later. You can also call our customer service number at 1-800-123-4567 for more information about Report 1: Intracameral cefuroxime and moxifloxacin prophylaxis for the prevention of postcataract endophthalmitis in rural India. The study evaluated visual acuity at near, intermediate and far ranges; contrast sensitivity (the ability to distinguish small differences between light and dark); and adverse events for six months after implantation. Cataracts may be diagnosed with procedures included in the comprehensive ophthalmologic examination. Fram NR, Masket S, Wang L. Comparison of intraoperative aberrometry, OCT-based IOL formula, Haigis-L, and Masket formulae for IOL power calculation after laser vision correction. Two authors independently assessed eligibility, extracted data and assessed the risk of bias. Eye (Lond). It is important that you check the details of the opacity a fixed focal length and provide clear vision a!, 2012 Medicare Coverage Uncovered the short answer: Yes study ; its findings need to validated... Details about the character, location, and extent of the insurance before! Practice decisions based on best clinical judgment until controlled trials are conducted and their findings.! Retrospective, cases-series study ; its findings need to be validated by well-designed studies anaesthesia for surgery... Ophthalmology ; 1991 be eligible for future updates of this review this was a retrospective, study... 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