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AIM: To compare and analyze the changes of the anterior corneal surface, posterior surface and total corneal high-order aberration between femtosecond small incision lenticule extraction(SMILE)and implantable collamer lens(ICL)in the correction of moderate and low myopia. <p>METHODS: Retrospective Study. Patients underwent SMILE surgery(<i>n</i>=35)or ICL surgery(<i>n</i>=35)with moderate or low myopia were selected in the refractive center of the Xi'an Aier Eye Hospital from November 2017 to February 2018. Before and 1, 3 and 6mo after surgery, the Scheimpflug phase formation based on Ray Tracing technology was applied to evaluate the anterior corneal surface, posterior surface and total corneal high-order aberration with a diameter of 6mm. Repeated measurement ANOVA was used to analyze the mean square root of corneal coma, spherical aberration and total high-order aberration at different time points. <p>RESULTS: The post-surgery uncorrected visual acuity of both the SMILE group and the ICL group at 1, 3, and 6mo reached or exceeded the pre-surgery best corrected visual acuity, and the pre-surgery corneal aberrations of the two groups were not statistically significant(<i>P</i>>0.05). One month after surgery, the precorneal high-order aberration of the SMILE group was significantly increased(<i>P</i><0.05), while the precorneal high-order aberration of the ICL group was unchanged(<i>P</i>>0.05). Post-corneal aberration of the two groups was not statistically significant(<i>P</i>>0.05). After surgery, and the differences of coma, spherical aberration and total high-order aberration between the two groups were not significantly(<i>P</i>>0.05). <p>CONCLUSION: Compared with SMILE surgery, precorneal high-order aberration induced by ICL is less for moderate and low myopia in the short term.