·AIM:To explore the long-term efficacy of myopic astigmatism treated by Q-factor guided laser epithelial keratomileusis(LASEK).·METHODS:Seventy-two cases(72 eyes)who were treated with Q-guided LASEK were trial group.66 cases(66 eyes)who were treated with conventional LASEK were control group.Naked distant and near visual acuity(VA),best-corrected VA,refractive diopters,intraocular pressure,topography,K value,Q value,wave-front aberration,contrast sensitivity,corneal thickness and haze of pre-and post-operation were detected.The patients were followed up for more than 12 months.·RESULTS:At 12 months post-operative,the naked VA of trial group was 1.12±0.16 while 1.07±0.14 for control group.The best-corrected VA of trial group was 1.16±0.19 while 1.12±0.17 for control group.Q value of trial group was 0.478±0.203 while 0.798±0.238 for control group.The difference was significant.Higher-order aberrations of trial group was 0.406±0.103μm while 0.613±0.105μm for control group.The difference was significant.Spherical aberration of trial group was-0.186±0.108μm,while-0.320±0.159μm for control group.The difference was significant.There was 0.125±0.275 haze in trial group while 0.375±0.535 in control group.Contrast sensitivity of trial group recovered to pre-operative level at 3 months post-operatively while control group delayed to recover until 6 months post-operatively.In trial group,contrast sensitivity of 12 months post-operative was better than pre-operative.The difference of two groups was more prominent in dark glare status.·CONCLUSION:Q-factor guided LASEK is safe and effective with good stability.Compared with conventional LASEK,Q-factor guided LASEK can reduce higher-order aberrations and spherical aberration induced by surgery.The results become better as longer follow-up time.The contrast sensitivity recovers sooner and with less haze postoperatively.Better visual quality can be achieved in Q-factor guided LASEK.·