A 29-year-old professional boxer with -4.0 D myopia and corneal thickness of 545 micrometres requests refractive surgery. Topography is normal and refraction has been stable for 3 years. The MOST appropriate procedure is:

• A LASIK with femtosecond flap
• B Conductive keratoplasty
• C Phakic intraocular lens
• D Surface ablation (PRK) ✓

Explanation

Athletes exposed to direct orbital trauma such as boxers are poor candidates for LASIK because a corneal flap can be dislodged or traumatised years after surgery. Surface ablation (PRK) avoids flap creation entirely by ablating Bowman layer and anterior stroma after epithelial removal, so it is the procedure of choice in contact-sport athletes. His refraction (-4.0 B) and thickness make a phakic IOL unnecessary.

Reference: Yanoff and Duker, Ophthalmology, 5th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.