AIM: To study the visual quality, dry eye and biomechanical stability of patients with myopia and astigmatism after different corneal refractive surgeries.

METHODS: A total of 986 patients with myopia and astigmatism were selected as the research object in our hospital from July 2015 to July 2016, according to the operation mode of the selection of the research object, the 986 patients were randomly divided into small incision lenticule extraction(SMILE)group, femtosecond laser in situ keratomileusis(FS-LASIK)group, sub-bowman-keratomileusis(SBK)group and laser-assisted in situ keratomileusis(LASIK)group. The postoperative visual quality was determined by comparing the diopter, uncorrected visual acuity(UCVA), best corrected visual acuity(BCVA)and high-order image difference of 25d, 90d. The postoperative dry eye condition was determined by comparing the postoperative tear secretion test(Schirmer Ⅰ test), tear film rupture time(BUT)and fluorescence staining(FS). The biomechanical stability of the patients was determined by comparing the corneal hysteresis(CH)and corneal resistance factor(CRF)values of the four groups.

RESULTS: The diopter, UCVA, BCVA and high-order aberration comparison of FS-LASIK group, SBK group and LASIK group between before and after surgery, showed no significant difference(P>0.05); on diopter, BCVA, UCVA, there was no significant difference between before and after surgery in SMILE group(P>0.05), but statistical significance difference on high order aberration(P<0.05). The BUT and FS value of the four groups decreased obviously after operation, and the difference was statistically significant(P<0.05). In LASIK group SIt after operation significantly decreased, with statistically significant compared with that before operation(P<0.05). After operation, CH and CRF of the four groups decreased with significant differences(P<0.05).

CONCLUSION: SMILE, FS-LASIK, SBK and LASIK are equally safe, effective and stable in the treatment of myopia and astigmatism.