
doi: 10.1056/nejmcp033210
A 32-year-old woman with moderate myopia and mild dry eye has worn soft contact lenses for 12 years but now is not tolerating them well. On examination, her refraction is –4.25 + 1.0 × 90 (–3.75 diopters of spherical equivalent and 1 diopter of astigmatism at 90 degrees) in the right eye and –3.5 + 0.5 × 88 in the left eye, yielding a best corrected visual acuity of 20/20 in each eye. She asks about refractive surgery. What would you advise?
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