AIM: To assess the changes on higher-order aberrations(HOA)after three different corneal refractive surgeries, including laser-assisted in situ keratomileusis(LASIK), femtosecond LASIK(FS-LASIK)and femtosecond lenticule extraction(FLEx).

METHODS: One hundred and twenty-five patients(245 eyes)from June 2014 to March 2015 in refractive surgery center of our hospital were recruited. There were 38 patients(74 eyes)underwent LASIK, 42 patients(83 eyes)underwent FS-LASIK, and 45 patients(88 eyes)underwent FLEx. The higher-order aberrations were measured preoperatively, at 1mo after surgeries with iTrace. The repeated measure of ANOVA was used to analyze the changes on higher-order aberrations among the groups.

RESULTS: Compared to the preoperative corneal higher-order aberrations, vertical coma aberration, horizontal coma aberration and spherical aberration, there were significantly differences in the three groups postoperatively(P=0.002, <0.01, <0.01, <0.01), which meant the three different surgeries effected the higher-order aberrations. Among these three different groups, we found that there were no significantly difference on total HOA, horizontal coma aberration and spherical aberrations(P>0.05). But it showed difference on vertical coma aberration(F=3.943,P=0.021). By multiple comparisons, there were statistical significance on vertical coma aberration between FLEx group and the other two.

CONCLUSION: The postoperative corneal higher-order aberrations all in creased in three groups. Due to the large incision in FLEx, the corneal aberration is still increased after surgeries. And the FLEx does not show a certain advantage yet.