Zonular Dehiscence Right & Left Eye ICD-10 & CPT Code

During cataract surgery, difficulties may arise if there is significant zonular dehiscence or weakening. It is possible that the ophthalmologist will not be able to detect the instability of a thick cataract until the earliest phases of cataract surgery, specifically the development of the capsulorhexis. At this point, the ophthalmologist may see the unusual motion of the lens or wrinkling of the capsule. Due to the increased risk of complications, surgeons must remain vigilant while treating post-traumatic or post-vitrectomy eyes. Sometimes, like in this case, the lens has moved a lot, and dilating the pupil can show an irregular equatorial area of the cataract where the zonules are visually missing.

What is Zonular Dehiscence?

When the fibrous bands that hold the crystalline lens to the ciliary body of the eye rupture, this condition is known as zonular dehiscence. Marfan syndrome, ectopia lentis (both hereditary and idiopathic), homocystinuria, and chronic scleritis are all possible underlying causes. Dense cataracts can make it difficult to identify zonular dehiscence or weakening during cataract surgery. In the event that it is present, it requires careful management in order to prevent complications.

Definition

Zonulopathy is a condition characterized by inadequate zonular support for the lenticular capsule. In certain circumstances, zonulopathy may be accompanied by lens malposition (subluxation or dislocation), however, in the majority of instances, no lens malposition is observed. This condition is sometimes referred to as zonular dehiscence or zonular dialysis.

Zonular Dehiscence Right & Left Eye

The term "zonular dehiscence" describes a disorder in which the eye's lens support fibers are harmed or weakened, allowing the lens to shift and become unstable. It has the potential to affect either the right or left eye. Surgery may be necessary to rectify it because it may cause visual issues.

The zonular fibers, also referred to as the zonular apparatus or zonule of Zinn, emerge from the ciliary body's non-pigmented basal laminae and enter into the lens capsule at the equatorial zone. The diameter of the fibers ranges from 5 to 30 um, and they are inserted 1.25 mm posteriorly and 1.5 mm anteriorly to the equator. The zonular apparatus is made up of about 140 fiber bundles, with fibrillin, a collagenous glycoprotein, playing a crucial role in the fibers' strength and elasticity. The FBN1 gene, which is abnormal in Marfan syndrome and responsible for coding fibrillin, contributes to poor zonular stability and lens subluxation.

Zonular Dehiscence ICD-10

Zonular dehiscence has the ICD-10 code H27.8. This code is intended to describe a medical diagnosis of various specific lens abnormalities and is valid through the fiscal year 2023. It can also be used to denote illnesses like iridodialysis (H21.53), floppy iris syndrome (H21.81), or other known or unknown lens abnormalities.

Zonular Dehiscence CPT code

CPT code 66982 describes zonular dehiscence. This number designates a complicated cataract procedure that includes extracapsular lens extraction, zonular dehiscence repair, and/or intraocular lens implantation. For the purpose of reimbursement, a diagnosis may also be indicated using the ICD-10 code H27.8.