[Hinews] [Physician's Column] By Young-geun Han, Director of SNU Clear Eye Clinic

For those who rely on glasses or contact lenses, the idea of vision correction surgery is often appealing. In recent years, laser-based procedures like LASIK and LASEK, which reshape the cornea, have gained popularity for their relative simplicity. However, for individuals with severe refractive errors—particularly high myopia exceeding -6 diopters or significant astigmatism—these options may not always be viable.

In cases of high myopia or severe astigmatism, correcting the refractive error requires removing a substantial amount of corneal tissue. Excessive corneal thinning can compromise the eye’s structural integrity, increasing the risk of postoperative complications. In some instances, patients may be deemed ineligible for laser surgery altogether. While advancements in laser technology have reduced the amount of corneal tissue removed, these innovations often remain insufficient for extreme cases like ultra-high myopia or severe astigmatism.

Eye anatomy also plays a critical role in determining surgical suitability. Patients with naturally thin corneas, unusually large pupils (which can lead to significant nighttime glare), chronic corneal conditions, or extreme astigmatism may not be ideal candidates for traditional laser procedures.
An alternative for such patients is intraocular lens implantation, a surgical procedure that places a corrective lens inside the eye. Unlike laser surgery, this method does not involve altering the cornea, making it suitable for individuals regardless of corneal thickness or shape. It also preserves the eye’s natural structure and offers the unique advantage of reversibility—implanted lenses can be removed if complications arise.

Young-geun Han, Director of SNU Clear Eye Clinic.
Young-geun Han, Director of SNU Clear Eye Clinic.


Intraocular lens implantation typically involves placing the lens either in front of or behind the iris. Posterior chamber lens implantation, where the lens is positioned between the iris and the natural lens, has become increasingly common. This approach is associated with minimal postoperative discomfort and rapid recovery, allowing patients to resume daily activities quickly. By avoiding corneal reshaping, it reduces the likelihood of side effects like dry eye syndrome or nighttime glare and is suitable for those with thin corneas.

However, intraocular lens implantation is not without risks. The lens must precisely match the eye’s internal dimensions to avoid complications. An oversized lens can obstruct the flow of aqueous humor, potentially increasing intraocular pressure and leading to glaucoma. Conversely, a lens that is too small may shift, risking damage to the corneal endothelium or the development of cataracts. Given these complexities, the procedure demands meticulous preoperative measurements of the eye’s internal structure, astigmatism axis, and other parameters, as well as a surgical team with extensive expertise.
Postoperative care is equally critical. Regular checkups are necessary to monitor corneal endothelial cell counts and ensure the lens remains properly positioned. Compared to LASIK or LASEK, intraocular lens implantation requires more rigorous follow-up care, making it essential to choose a medical facility with a robust preoperative and postoperative care system.

For individuals with high myopia or astigmatism who are ineligible for laser surgery, intraocular lens implantation offers a practical solution. It is also an option for those requiring re-correction or with corneas too thin for laser procedures. However, because the surgery involves placing a lens directly inside the eye, thorough preoperative evaluations and consistent postoperative management are vital.

Consulting with experienced, reputable ophthalmologists to determine the most suitable procedure for your eyes is strongly recommended.

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