The National Institute for Health and Clinical Excellence (NICE) has issued full guidance to the NHS in England, Wales, Scotland and Northern Ireland on Macular translocation with 360° retinotomy for wet age related macular degeneration.
NICE has also issued full guidance on limited macular translocation for wet age related macular degeneration (NICE interventional procedures guidance 339).
These replace the previous guidance on Macular translocation for age-related macular degeneration (NICE interventional procedures guidance 48, March 2004).
Age-related macular degeneration is an eye disorder that causes problems with central vision (seeing things straight in front of you) and affecting the part of the retina (the back of the eye) called the macula. Wet macular degeneration happens because fluid leaks into the area under the macula causing scarring.
The aim of macular translocation is to improve vision. It involves cutting and moving the macula on to a nearby healthier area of the choroid layer. The macula is moved from its normal position by making a cut around the edge of the retina. This is called macular translocation with 360 degree retinotomy.
For the 1st stage of the procedure the following OPCS-4 codes are selected:
C83.2 Macular translocation three hundred and sixty degrees
C79.6 Internal tamponade of retina using liquid
Includes: Internal tamponade of retina using oil or heavy liquids
Y70.3 First stage of staged operations NOC
OPCS-4 codes for the second stage of the procedure will be dependent on which muscles are divided and reattached.
In addition ICD-10 code H35.3 Degeneration of macula and posterior pole is assigned.
This guidance represents the view of NICE, arrived at after careful consideration of the evidence available. When exercising their judgement, healthcare professionals are expected to take this guidance fully into account. However, the guidance does not override the individual responsibility of healthcare professionals to make decisions appropriate to the circumstances of the individual patient, in consultation with the patient and/or guardian or carer.
Commissioners and/or providers have a responsibility to implement the guidance, in their local context, in light of their duties to have due regard to the need to eliminate unlawful discrimination, advance equality of opportunity, and foster good relations. Nothing in this guidance should be interpreted in a way that would be inconsistent with compliance with those duties.
Commissioners and providers have a responsibility to promote an environmentally sustainable health and care system and should assess and reduce the environmental impact of implementing NICE recommendations wherever possible.