Keratoprosthesis

Covers implantation of keratoprostheses (e.g., Boston KPro types I/II and AlphaCor) to restore vision in patients with severe corneal opacification or vascularized corneas—such as prior failed grafts, Stevens–Johnson syndrome, ocular cicatricial pemphigoid, chemical burns, or limbal stem cell failure—when penetrating keratoplasty has failed or is unlikely to succeed, provided affected-eye BCVA ≤20/400, contralateral-eye BCVA ≤20/40, and no end‑stage glaucoma or retinal detachment. Coverage is limited to the specified devices and indications; other permanent KPros and investigational materials are not covered, and implantation must meet all conjunctive criteria, be performed by experienced surgeons at specialized centers, and involve patients able to comply with intensive postoperative care due to high complication and reoperation risk.

"Boston (Dohlman-Doane) Keratoprosthesis (Boston KPro) for surgical treatment of severe corneal opacification (corneal blindness) when cadaveric corneal transplants have failed."