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Options for high myopia: LASIK, SMILE, ICL or lens? (2026)

For high myopia (about −6.00 D and above), options are LASIK or SMILE if your cornea is thick enough, surface laser at moderate levels, an EVO ICL (−3.00 to −20.00 D in the US) or, after the mid-40s, lens replacement. Above about −10.00 D, ICL is often discussed first.
Reviewed November 2026 · Seoul LASIK Clinic Directory
Options for high myopia: LASIK, SMILE, ICL or lens? (2026)

What are the options for high myopia?

High myopia is usually defined as about −6.00 D or more. You may still have several choices: LASIK or SMILE if your cornea is thick and healthy enough, surface laser at moderate levels, an implantable lens such as the EVO ICL, or, from the mid-40s, lens replacement. The higher your prescription, the more often an implantable lens is recommended.

The AAO lists extreme nearsightedness and thin corneas among reasons not to have LASIK, so the exam matters more than the number on your glasses. Facts on this page were checked on 1 November 2026. Read about the condition in high myopia.

How do the options compare?

Option Range (published US) Tissue removed Key trade-off
LASIK Up to about −12.00 D, by laser Yes, under a flap Deep ablation at high powers; cornea limits
SMILE / SMILE Pro −1.00 to −10.00 D (ZEISS) Yes, lenticule via small incision Flapless; myopia only
LASEK / PRK Moderate myopia commonly Yes, from the surface Slower, more painful recovery; haze risk rises with power
EVO ICL −3.00 to −20.00 D None; lens added Surgery inside the eye; removable
Lens replacement Wide range Natural lens replaced Usually 45+; retinal risks to discuss

When is LASIK or SMILE still possible?

When your cornea is thick and regular enough to leave a safe amount of untouched tissue after treatment. Higher prescriptions need more tissue removed, and the FDA warns that reshaping a cornea that is too thin may result in blinding complications. So a patient at −8.00 D with a thick cornea may be suitable, while another at −7.00 D with a thin cornea is not. See corneal thickness for LASIK and LASIK prescription limits.

SMILE, including SMILE Pro on the VisuMax 800, treats myopia up to −10.00 D in its US range, without a flap. Large pupils also matter more at high corrections: the FDA notes they can cause glare and halos after surgery.

Why is ICL often recommended for high myopia?

Because it corrects the prescription without removing corneal tissue. The EVO ICL sits in front of your natural lens. Its US FDA indication covers −3.00 to −20.00 D, with toric versions for 1.00 to 4.00 D of astigmatism; in 2026 the age range was widened to 21–60. The label requires an anterior chamber depth of at least 3.00 mm and a prescription stable within 0.50 D for a year. Learn more in ICL surgery in Korea and ICL vs LASIK.

How do I choose between them?

Work through these questions with your surgeon, in this order:

  1. Is my prescription stable? The FDA flags any change in the past year, and the EVO ICL label asks for stability within 0.50 D for a year. If it is still changing, wait.
  2. Is my cornea thick and regular? If not, corneal laser options narrow and ICL moves up the list.
  3. Is the space inside my eye large enough for a lens? The US EVO ICL label needs an anterior chamber depth of at least 3.00 mm.
  4. How old am I, and how healthy is my natural lens? From the mid-40s, presbyopia and early lens changes make lens replacement worth discussing.
  5. What matters most to me? Night driving, contact sports, budget and how much recovery time you have all shift the balance.

Ask the surgeon to explain why they recommend one option over the others for your eyes, using your own measurements. If two clinics disagree, that is a reason to ask more questions, not to pick the cheaper answer. See questions to ask your LASIK surgeon.

What are the risks of each option?

All have real risks, stated plainly:

  • LASIK and SMILE: dry eye, glare and halos, under- or over-correction and, rarely, corneal ectasia; see LASIK side effects
  • LASEK and PRK: several days of discomfort and slower recovery, and a higher risk of haze at stronger corrections
  • ICL: intraocular surgery carries risks such as raised eye pressure, cataract and, rarely, infection; the lens may need exchanging if sizing is not right
  • Lens replacement: the risks of cataract surgery, plus a retinal detachment risk to discuss for highly myopic eyes

Does surgery fix the retinal risks of high myopia?

No. Surgery corrects focus but does not change the length of the eye, so the retinal checks recommended for highly myopic eyes still apply afterwards. Your pre-op exam should include a dilated retina check, and you should keep having regular eye exams at home.

What about Artisan and Artiflex lenses?

These are iris-fixated phakic lenses, an alternative implantable option for some eyes. Compare them in EVO ICL vs Artisan and Artisan/Artiflex lens in Korea.

How much does each option cost in Seoul?

Procedure Seoul price, both eyes (2026) Approx. USD
LASIK ₩1.5M–₩2.5M $1,100–$1,900
SMILE ₩2.2M–₩3.2M $1,600–$2,400
SMILE Pro ₩3M–₩5M $2,200–$3,700
ICL / EVO ICL ₩4M–₩6.5M $2,900–$4,700
Toric ICL ₩5M–₩7.5M $3,600–$5,500

USD at roughly ₩1,350–1,400 = $1. See cost of ICL in Korea.

This page is general information. Only a full exam and an ophthalmologist's advice can say which option is safe for you.

Sources

Key facts

  • LASIK: up to about −12.00 D by laser label; cornea often limits it sooner
  • SMILE (ZEISS, US): up to −10.00 D
  • EVO ICL (US): −3.00 to −20.00 D; ages 21–60
  • Retina: highly myopic eyes still need regular retina checks after surgery
  • ICL price: ₩4M–₩6.5M for both eyes

Independent directory. Prices are typical ranges reported by Seoul clinics and change often. Always confirm a written quote and get a full eye exam before booking. This page is general information, not medical advice.

FAQ

Frequently asked questions

What is the best surgery for high myopia?

There is no single best option. ICL is often recommended at higher prescriptions because it removes no corneal tissue, while LASIK or SMILE can suit people with thick, healthy corneas.

Can SMILE treat high myopia?

Yes, up to −10.00 D in ZEISS's US range, if your cornea is thick enough. Above that, ICL is usually discussed.

Is ICL safe for −12 or higher?

The EVO ICL's US indication goes to −20.00 D. Like any eye surgery it has risks, including raised eye pressure and cataract, which your surgeon should explain.

Does LASIK cure high myopia?

It corrects the focus but not the length of the eye. Retinal risks linked to high myopia remain, so regular retina checks still matter.

What if my cornea is too thin for LASIK?

ICL or, at moderate prescriptions, surface laser such as LASEK or PRK may be options. Your surgeon will compare them using your measurements.

Planning vision correction in Seoul?

Compare clinics by district, check 2026 price ranges, and read our step-by-step planning guide for international patients.