20/20 REFRACTIVE MATCHER −3.0 D −6.0 D −10.0 D SMILE PRK LASIK ICL RLE AAO PPP 2025
Decision · By Prescription

Your Options, Diopter by Diopter.

Reviewed by Editorial Board (named board-certified ophthalmologist pending). Last reviewed 2026-06-10.

Your prescription is the first filter, it decides which procedures are even on the table, before your cornea decides among them. The verified FDA ranges: SMILE treats −1.0 to −10.0 D (NBK549896, FDA P150040), the EVO ICL −3.0 to −20.0 D (PMC11110473), and LASIK/PRK occupy the low-to-moderate band their tissue budgets allow. Here is the whole map.

A trial lens kit with rows of labeled lenses in a wooden case
Every diopter band opens a different set of doors.
The Map

Procedures by myopia band.

Your myopiaOn the tableWhat actually decides
−1 to −3 DLASIK · PRK · SMILECornea and dry eye; ICL range hasn't started yet
−3 to −6 DLASIK · PRK · SMILE · ICLAll doors open; anatomy and lifestyle pick
−6 to −10 DSMILE (to −10) · LASIK/PRK if tissue allows · ICLResidual stromal bed math starts disqualifying lasers
−10 to −20 DICL (to −20) · RLE in presbyopic agesBeyond all corneal lasers; intraocular options only
beyond −20 DNo approved refractive procedureGlasses/contacts; retina-aware monitoring

Astigmatism rides along: SMILE to −3.0 D cylinder, EVO ICL to −4.0 D. Hyperopia is a different map, and a smaller one, ask specifically if you are plus-powered. Sources: NBK549896, FDA P150040, PMC11110473.

The Catch

Why the table is necessary but not sufficient.

The ranges above are FDA labels, not promises about your eye. Two examples of how anatomy overrules arithmetic. A −7 D myope is inside SMILE's range, but on a 490 µm cornea the predicted residual stromal bed can fall below the ~250 µm floor (NBK549896), and the laser option dies on the spot, while the ICL doesn't care. Conversely, a −16 D myope is comfortably inside the ICL's range, but a shallow anterior chamber under the ~2.8 to 3.0 mm floor closes that door too, and the conversation moves to RLE, where the high-myope retinal detachment numbers (1.5 to 8 percent, PMC7856935) become the real subject.

That is the design logic of the Procedure Matcher: it applies the prescription gates and the anatomy gates together, which is the only way the answer means anything.

Myth Busted

"Any prescription can be lasered."

False. SMILE's approval stops at −10.0 D, and LASIK/PRK stop wherever your corneal tissue budget says they stop, frequently earlier. Deep myopia is intraocular territory: the ICL to −20.0 D, RLE for the presbyopic. A clinic offering to laser a −12 D cornea is proposing to spend tissue the math says isn't there.

Next

Go one level deeper.

Inside the laser band, the three-way trade-offs live in LASIK vs PRK vs SMILE. At the high end, read the EVO ICL guide and the RLE presbyopia guide, the risk profiles differ in kind. And whatever band you sit in, the candidacy gates decide before preference does.

Educational content, not medical advice; an in-person exam with topography and biometry decides candidacy. Sources: NBK549896, FDA P150040, PMC11110473, PMC7856935. See all sources.

Frequently asked questions

What surgery can I get with mild myopia (−1 to −3 D)?

All three corneal lasers compete here: LASIK, PRK and SMILE (SMILE’s FDA range starts at −1.0 D). The ICL generally does not, its FDA range starts at −3.0 D, and at this level the corneal options are simpler. The decider in this band is corneal anatomy and dry-eye status, not the prescription.

What are my options at −6 D?

Everything: LASIK, PRK and SMILE all cover −6 D comfortably (SMILE runs to −10 D), and the ICL range includes it too. With all doors open, the choice turns on your cornea’s thickness and shape, dry-eye profile, and lifestyle factors, exactly the trade-offs in our three-way laser comparison.

What if my prescription is −12 D?

You are beyond every corneal laser: SMILE stops at −10 D, and LASIK/PRK rarely reach that deep on real corneas because of tissue limits. The EVO ICL, FDA-approved to −20.0 D, is the primary surgical option, with RLE as the lens-based alternative in older patients.

Is any surgery approved beyond −20 D?

No FDA-approved refractive implant or laser covers beyond −20.0 D, the ICL’s ceiling. Options at that extreme are off-label combinations or simply correction with glasses and contacts, and a retina-aware exam matters more than ever at that axial length.

How much astigmatism can each procedure correct?

SMILE’s FDA approval covers cylinder up to −3.0 D and the EVO ICL up to −4.0 D. LASIK and PRK handle common astigmatism levels as well. High or irregular astigmatism is a topography question first, irregular patterns suggest keratoconus screening before any surgery talk.