Qin B, et al. - In this prospective study involving 60 patients, researchers compared the clinical results of femtosecond laser small-incision lenticule extraction (SMILE), a newly developed refractive surgical technique, for the correction of myopia and myopic astigmatism greater than − 10 D, and − 10 D or less respectively. According to results, visual outcomes exhibited similar outcomes of SMILE for myopic correction of > − 10 D and ≤ − 10 D. In higher myopic eyes, refractive outcomes displayed slightly under-correction. Findings revealed that higher myopic treatment tends to cause more spherical aberrations. Micro-distortions in Bowman’s layer were correlated with preoperative spherical equivalent and lenticule thickness, but did not affect visual and refractive results. In terms of extending the SMILE indications, this procedure seems promising.