A 26-year-old woman has myopia of −16.0 D with a corneal thickness of 480 µm, normal topography and a clear crystalline lens. She wants spectacle independence. The most appropriate surgical option is:
- A Implantation of a posterior chamber phakic intraocular lens ✓
- B LASIK with a small optical zone to conserve tissue
- C Repeat PRK combined with mitomycin C
- D Conductive keratoplasty in both eyes
Correct answer: A. Implantation of a posterior chamber phakic intraocular lens
Explanation
At −16.0 D with a 480 µm cornea, laser ablation cannot achieve emmetropia while leaving an adequate residual stromal bed, so corneal laser surgery is contraindicated. B phakic IOL corrects very high myopia while preserving accommodation and corneal structure; requirements include an endothelial cell count above threshold, an anterior chamber depth of at least 2.8 to 3.0 mm and stable refraction. Conductive keratoplasty treats low hyperopia only and cannot address axial myopia of this magnitude.
Reference: AAO Basic and Clinical Science Course, Section 13: Refractive Surgery, 2022-2023 ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.