August 2016 - NICE is updating this guidance (see the in development page for information). The NHS should continue to follow the recommendations in this guidance until the update is complete.

The National Institute for Health and Clinical Excellence (NICE) has issued full guidance to the NHS in England, Wales, Scotland and Northern Ireland on Trabecular stent bypass microsurgery for open angle glaucoma.


Primary open-angle glaucoma is a condition associated with a long-term increase of pressure within the eye. It may gradually lead to permanent loss of sight because of damage to the nerve that connects the eye to the brain (optic nerve).

This new procedure involves inserting a hollow metal tube (stent) into the eye in order to help fluid to drain from the front chamber of the eye.

Coding recommendations

C60.5 Insertion of tube into anterior chamber of eye to assist drainage of aqueous humour

Y14.3 Insertion of metal stent into organ NOC

Note: An alternative code from category Y14.- Placement of stent into organ NOC may be assigned if a different  type of stent is used.

OPCS-4 codes are assigned in addition if phacoemulsification and insertion of an intraocular lens is performed at the same time as the procedure.

In addition ICD-10 code H40.1 Primary open-angle glaucoma is assigned.

Your responsibility

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.

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