We can agree that a refractive lens exchange is a good way to address high hyperopia in presbyopic patients, but what about to address high myopia? We know that the risks are different, particular when it comes to retinal complications such as retinal detachment. And that there are certain risk factors such as prior retinal issues, young age, longer axial length, and absence of a PVD (posterior vitreous detachment). So when is it reasonable to proceed with refractive lens exchange for highly myopic patients? Please let me know your thoughts and parameters for guiding these patients.