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Corneal cross-linking patients need Medicare rebate

10 April 2015

In a recent article in the Optometry Australian, February 2015 edition, the Department of Health had received a request for Medicare Benefits for patients undergoing Cross-linking as early intervention in progressive Keratoconus. Keratoconus is the thinning of the central zone of the cornea, causing it to become steepened, and affects roughly 1 in 2500 people.

Keratoconus Australia is a not for profit organisation aimed to prevent and control any visual impairment caused by Keratoconus. They have announced they will support the rebate for the cross-linking procedure when approved, as long as clinically proven protocols can demonstrate to be safe and effective long term. Keratoconus Australia President Larry Kornhauser has spoken about his concerns towards the long waiting lists as well as high costs Keratoconic patients face when looking to go ahead with the corneal cross- linking procedure.

“The application to the department of health is probably overdue as many patients are finding it difficult to access this potentially useful procedure because of the high cost, which averages around $2,500 per eye… However there is an increasing range of variations of the procedure, mostly unproven, and patients and their families are bewildered by the array of options being offered by corneal surgeons in Australia.”

Consultant ophthalmologist at the Royal Victorian Eye and Ear Hospital Dr Elsie Chan has been involved in the world’s first randomised controlled clinical trial of corneal cross-linking at Centre for Eye Research Australia (CERA). Three years after the Cross-linking procedure in 48 control and 46 treated eyes of patients with progressive keratoconus, found at 36 months there was a sustained improvement in maximum simulated keratometry value, uncorrected visual acuity and best spectacle-corrected visual acuity in the treated group of people, whereas the control group demonstrated further progression.

“Should the proposal proceed for consideration through the Medicare Services Advisory Committee process, a consultation protocol for the application will be published on the Medical Services Advisory Committee (MSAC) website and public submissions invited.”

Dr Chan suggested a Medicare rebate was needed, as the procedure would hopefully help prevent progression of the disease and the need for corneal transplant. Cross-linking would also hopefully help prevent the need for costly contact lenses and associated costs of rebate visits and updated lenses. Patients are currently paying out of their pockets or having the procedure done at a public hospital if that hospital offers the treatment with no costs. Dr Chan said in a seminar in 2013

“results showed that cross-linking slowed and might halt progression of Keratoconus with a small risk of complications, and variations to the procedure had been performed”. She also stated at the seminar that ‘’there was no evidence of benefit to those not experiencing demonstrable progression.”

(Extract from article in Australian Optometry February 2015- Corneal Cross-linking patients need Medicare rebate.)

At Hunter Laser Vision we monitor patients with Keratoconus and perform Ultra Violet Light Crosslinking on those with progressive disease to halt any further deterioration of best corrected and unaided visual acuity. We have been performing treatments for the past 7 years and see patients from all over NSW. A small percentage of patients may also be suitable for Kerarings, a semicircular polymer that can be inserted into the cornea after a channel has been created with a femtosecond laser. If you are interested in booking a Keratoconus Assessment to determine suitability for our Corneal Cross-Linking procedure please call our rooms at The Junction on 1800 44 20 20 or book online here

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