A 30-year-old with -16.0 D myopia, normal corneal topography, corneal thickness of 498 micrometres, and endothelial cell count of 2600 cells/mm2 seeks surgical freedom from glasses. The MOST suitable procedure is:
- A LASIK
- B PRK with mitomycin C
- C Implantable collamer lens (phakic IOL) ✓
- D Clear lens extraction with monofocal IOL
Correct answer: C. Implantable collamer lens (phakic IOL)
Explanation
Corrections beyond about -10 D are unsuitable for corneal laser ablation: the required ablation depth would leave an unsafe residual bed on a 498 micrometre cornea and induce unacceptable higher-order aberrations. A phakic IOL placed in the posterior chamber preserves the crystalline lens and accommodation and is the standard choice for high myopia with a healthy cornea. Clear lens extraction sacrifices accommodation and carries retinal detachment risk in a young high myope, so it is avoided here.
Reference: Khurana, Comprehensive Ophthalmology, 7th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.