Corneal collagen cross-linking (CXL) is a photochemical procedure approved by the Food and Drug Administration for the treatment of progressive keratoconus and corneal ectasia. Keratoconus is a dystrophy of the cornea characterized by progressive deformation (steepening) of the cornea while corneal ectasia is keratoconus that occurs after refractive surgery. Both lead to functional loss of vision and need for corneal transplantation.
Coverage is subject to the specific terms of the member's benefit plan
Corneal collagen cross-linking using riboflavin and ultraviolet A may be considered medically necessary as a treatment of progressive keratoconus or corneal ectasia after refractive surgery in patients who have failed conservative treatment (eg spectacle correction, rigid contact lens).
Corneal collagen cross-linking using riboflavin and ultraviolet A is considered investigational for all other indications.
Progressive keratoconus or corneal ectasia is defined as 1 or more of the following: