〔Abstract〕 To compare the change of posterior corneal higher-order aberrations(HOA) of myopic eyes after four refractive surgeries including laser in situ keratomileusis(LASIK), femtosecond laser-assisted laser in situ keratomileusis(FS-LASIK), wavefront-guided LASIK with iris registration(WF-LASIK), and small incision lenticule extraction(SMILE). A total of 242 subjects(46 subjects underwent LASIK, 38 subjects underwent FS-LASIK, 68 subjects underwent WF-LASIK, and 90 subjects underwent SMILE) were involved. HOAs of each patient's right eye were measured with Pentacam device preoperatively and 6 months after surgery. The aberrations were described as zernike polynomials, and analysis was focused on total HOAs, spherical aberration(SA), coma, horizontal coma, and vertical coma over 6 mm diameter central corneal zone. In LASIK group, pre-and postoperative total HOA, SA and horizontal coma were not statistically significantly different, but postoperative coma and vertical coma were significantly different(P<0.01). In FS-and WF-LASIK groups, significant differences were found in the total HOA, SA and coma(P<0.05) while no difference was found in the horizontal coma and vertical coma. In addition, all HOAs were found to have significantdifferences between pre-and postoperative SMILE procedure(P<0.01). The result showed that SMILE induced significantly negative shift in horizontal coma compared with FS-LASIK and WF-LASIK(P<0.01). Meanwhile, SMILE group also had a significant increase in vertical coma compared with FS-LASIK and WF-LASIK(P<0.01). In LASIK and the other groups, induced total HOAs, SA, coma, horizontal coma and vertical coma were all comparable.SMILE induced more horizontal coma and vertical coma compared with FS-LASKandWF-LASIK, indicating that the centration of SMILE procedure is probably less precise.