AIM: To explore the effects of femtosecond laser-assisted in situ keratomileusis(FS-LASIK), topography guided LASIK(TG-LASIK)and small incision lenticule extraction(SMILE)on postoperative visual quality and higher-order aberrations(HOA)in patients with refractive errors.

METHODS: A total of 296 patients(586 eyes)with simple myopia or myopic astigmatism who were admitted to refractive center of the hospital between December 2019 and February 2020 were enrolled. Under the premise of determining surgical indications, the patients chose to undergo FS-LASIK, TG-LASIK and SMILE voluntarily. Among them, there were 95 cases(189 eyes)in FS-LASIK group, 104 cases(205 eyes)in TG-LASIK group and 97 cases(192 eyes)in SMILE group. The data such as visual acuity, diopter, corneal topography, HOA and contrast sensitivity were collected before and at 6, 12mo after surgery.

RESULTS:The uncorrected visual acuity, best corrected visual acuity, spherical equivalent and spherical equivalent refraction at 6mo after surgery were better than those before surgery(P<0.05), and there was no significant difference among different groups(P>0.05). At 6, 12mo after surgery, regularity index of corneal surface and surface asymmetry index in TG-LASIK group were significantly lower than those in SMILE group and FS-LASIK group(P<0.05), and there was no significant difference between SMILE group and FS-LASIK group(P>0.05). At 6, 12mo after surgery, total HOA, clover aberration and coma at 6mo spherical aberration in FS-LASIK group were significantly higher than those in TG-LASIK group and SMILE group(P<0.05), while the spherical aberration in the SMILE group was significantly lower than that of the other two groups(P<0.05). At 6, 12mo after surgery, contrast sensitivities with or without glare in TG-LASIK group were significantly higher than those in SMILE group and FS-LASIK group at frequencies of 12.0c/d and 18.0c/d(P<0.05).

CONCLUSION: The curative effect of FS-LASIK, TG-LASIK and SMILE are satisfactory. However, the aberration increase is less after TG-LASIK, the corneal topography is more regular, and the visual quality is higher.