AIM:To evaluate the effect of higher-order aberrations(HOAs)after topography-guided and wavefront-optimized femtosecond laser-assisted in situ keratomileusis(FS-LASIK).

METHODS: We searched on PubMed, the Cochrane Library, Medline, CNKI, CBM, VIP and WanFang Data database for randomized controlled trials(RCTs)and comparative studies(CTs). The published languages were limited to Chinese and English. The risk bias tool provided by the Cochrane cooperation scale and Newcastle-Ottawa Scale were used to assess the risk bias of included studies of RCTs and CTs. The published biases of included studies were assessed by the Egger test. Meta-analysis was performed with Review Manager 5.4.

RESULTS: Two randomized controlled trials and six comparative studies with a total of 987 subjects were included(482 in the topography-guided FS-LASIK group, 505 in the wavefront optimized FS-LASIK group). The Meta-analysis showed that the topography-guided group has a better effect than the wavefront-optimized group in spherical equivalent, the difference between the two groups was statistically significant \〖WMD=0.11, 95%CI (0.07, 0.14), P<0.00001\〗. And the results also indicated that there was a significant difference between the two groups with HOAs \〖WMD= -0.09, 95%CI (-0.13,-0.05), P<0.0001\〗, spherical aberrations \〖WMD=-0.05, 95%CI (-0.09, -0.01), P=0.008\〗 and coma \〖WMD=-0.08, 95%CI (-0.12, -0.05), P<0.00001\〗.

CONCLUSION: Based on the available evidence, topography-guided FS-LASIK has higher diopter and lower HOAs, spherical aberrations and coma than wavefront-optimized FS-LASIK.