05/26/2026
Case of the Month with Sanket Shah, MD:
A 23-year-old female is referred for a LASIK consult. Vision is 20/20 with refraction of -9.75 + 2.00 x 085. What would you recommend, and why?
A. LASIK
B. PRK
C. ICL
D. Observation
The correct answer is D✅. This patient appears to have forme fruste keratoconus (KCN), but does not yet meet the criteria for corneal cross-linking (CXL). If the condition remains stable over time, ICL would be the preferred surgical option. However, if progression or instability is detected, CXL should be performed prior to ICL. While procedures such as PRK may be possible in select cases, a corneal refractive procedure would generally not be preferred in an eye with ectasia risk.
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