If you have the last adventure in the AoW adventure path (Dawn of a New Age, Dungeon 135), use the advanced overworm listed there, it's advanced to about the right CR. For Makar, advance him to at least 18th level caster. Remember to up the DC for things like the Naga's gaze attacks too, as per the standard rules (+1 DC per 2 HD) - the Nagas are potentially nasty with their gaze attacks as they are, so just have a think about their power in relation to their CR after you've advanced them, it's not an exact science (my players thought the naga's should have been higher CR given what their gaze could do, even though no PC died - I agreed). Overall, it's always a bit tricky beefing up an adventure by so much (4-5 EL is a big jump), but I guess off the top of my head this one isn't so bad, it should still work reasonably well. Makar can quite easily go down quickly as written, so give him as many allies as possible, have him pre-cast things like freedom of movement etc (or make it an innate power of the spire), make sure that lake doesn't become a hindrance to his allies helping him (the swords of kyuss can't fly as written, I say give them that ability somehow), and be aware that your party may well strip all his good buffs with a greater spell or two, so to make him memorable his tactics in the first round need to be solid (he might never see round 2 if you're unlucky). For example, when I used him his only verbal spells were close range, and he was grappled with Telekinesis from across the lake, so he was effectively neutralised and could not get out before he was killed at range. He needs to take out one or more PC's in his first round, and his allies need to be a credible threat. I guess you need to decide exactly what kind of BBEG Makar should be - blaster, controller, or whatever. Controller might work well, just make sure he's got his weak spots covered (harder for an arcane caster than for a cleric, but at 18th level he should have wish etc to get himself out of trouble, and allies who can also get him out of a fix).
If there's one thing I've found in my own AoW campaign, it's that by the time your PC's are getting 9th level spells, they really can start to chew through moderately tough encounters very quickly, due to their spells but also due to the extensive magic items they have acquired. In fact, in my own game, the spell casters are having trouble keeping up with the melee characters in terms of damage output per round. So things like an advanced overworm are no real threat when the paladin can use multiple smites and deal 288 hp damage with one (hasted) full round attack, then the ogre fighter kensai does a max power attack and does 403 hp of damage with one (hasted) full round attack. The cleric ends up casting the odd mass heal plus some fluff spells, and the sorcerer/fighter/abjurant champion more often than not buffs himself way up to join in the melee as his spells don't do enough and save or die type spells generally don't have a high enough DC to be useful unless they can find a weak spot in the monster's save bonuses (like disintegrate vs undead, although mass heal still works the best there). So in my game at least, it's the melee guys who make the most impact in fights, especially now they all have boots of flying, armour of haste, +4 or +5 keen holy weapons with other effects on top for the kensai like axiomatic, undead bane, and ghost touch - against CE undead, he's rolling an insane number of damage dice...
Good luck, and have fun!
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I ran Spire of Long Shadows for my 16th level party of three, and a lot of the enemies seemed like a decent challenge as written. I think I added some hit points here and there to make the fights last long enough to feel like a challenge, but for the most part it went smoothly. One character annhilated a room full of wormswarms in one round through area-effect psionics, and I had no problem with that...every now and then, it's good to let the PCs soar through an easy fight without a scratch.
Makar was a little tougher for them. The psion failed at everything he tried to do to Makar, and the displacements and mirror image effects kept the soulknife busy for a while. I had Makar heal himself a couple of times, just as the group was getting him low, and eventually he got disintegrated.
The problem running Makar against a high level party will be their saving throws. Every high-level spell he tried to use against the PCs got stopped by the save. After a couple rounds of this, I switched tactics and he became much more effective: His spellweaving lets him cast a separate first-level spell with each of his six hands, and he put that to shockingly good use on round three or four, dropping the soulknife to negative hit points instantly with a full barrage of seven magic missile spells: one for each hand, plus one quickened spell for good measure. (I gave him a quicken spell effect and let it work with his spontaneous casting to make him more dangerous for my higher-level PCs. It worked--the 7th magic missile spell is the one that put down the soulknife...)
Anyway, Makar doesn't have a tremendous amount of hit points, so a high-level group that can defeat his illusions and other defenses to land a few hits will make short work of him. That said, you want to make sure to get some dialogue in before it comes to blows. Makar has a lot of valuable insight into the Age of Worms, and it would be a shame for the PCs to waste an opportunity to talk to one of the few remaining creatures in the world who actually knew Kyuss as a mortal...