CPT® Code 0402T

Collagen cross-linking of cornea, including removal of the corneal epithelium, when performed, and intraoperative pachymetry, when performed

Collagen cross-linking of the cornea is a specialized ophthalmic procedure aimed at enhancing the structural integrity of the cornea by strengthening the collagen fibers within it. This is achieved through the application of riboflavin, also known as Vitamin B2, in conjunction with ultraviolet-A (UV-A) light. The procedure is particularly beneficial for patients suffering from conditions such as keratoconus, pellucid marginal degeneration, and ectasia that may arise following LASIK surgery. By increasing the number of fiber anchors that bond collagen together, collagen cross-linking serves as a first-line treatment option to stabilize the cornea and prevent further progression of these conditions. Additionally, this technique may be employed to address corneal ulcers and infections, as well as to secure Intacs, which are small plastic discs implanted within the cornea to improve its shape. During the procedure, the patient is positioned reclining, and a lid speculum is utilized to keep the eyelids open. Anesthetic eye drops are administered to ensure patient comfort. The procedure may involve the removal of a thin layer of corneal epithelium to facilitate quicker absorption of riboflavin, although it can also be performed as a transepithelial procedure with the epithelium intact. The riboflavin solution is applied at specific intervals until it is detected in the anterior chamber of the eye, confirmed by a blue filter on a slit lamp. Following this, UV-A light is directed at the corneal apex for a predetermined duration to initiate the cross-linking process. Post-treatment, ultrasound pachymetry may be conducted to assess the corneal thickness, and antibiotic eye drops are applied, followed by the placement of a bandage contact lens to aid in recovery.