The National Institute for Health and Care Excellence (NICE) has issued full guidance to the NHS in England, Wales, Scotland and Northern Ireland on Insertion of an epiretinal prosthesis for retinitis pigmentosa, in June 2015.
Retinitis pigmentosa is the encompassing term for a group of degenerative eye conditions that cause progressive loss of retinal photoreceptors. The disease is often inherited. Patients initially experience ring scotoma and night vision problems which, in most cases, slowly progress and lead to the loss of all peripheral vision. Central vision is usually preserved until late stages of the disease, but can be lost earlier with severe disease.
Conservative treatment strategies are aimed at early identification and treatment of complications such as cataract or macular oedema. Some newer treatments aim to slow the progression of the condition. Surgical treatments are being developed; including subretinal and epiretinal prostheses, as well as optic nerve implants to restore basic sight.
The OPCS-4 codes for Insertion of an epriretinal prosthesis system for retinitis pigmentosa are:
C84.8 Other specified other operations on retina
Y02.1 Insertion of prosthesis into organ NOC
In addition the ICD-10 code H35.5 Hereditary retinal dystrophy would be recorded.
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, and specifically any special arrangements relating to the introduction of new interventional procedures. 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.
All problems (adverse events) related to a medicine or medical device used for treatment or in a procedure should be reported to the Medicines and Healthcare products Regulatory Agency using the Yellow Card Scheme.
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. Providers should ensure that governance structures are in place to review, authorise and monitor the introduction of new devices and procedures.
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.