Objective To evaluate and compare dry eye parameters after femtosecond LASIK and SMILE surgery by conducting a systematic review of the literature． Methods This was a meta-analysis study． Using the Cochrane system evaluation method, a meta-analysis search of PubMed, Web of Science, superstar Medalink, Chinese biomedical literature database (CBM disc), CNKI and Wanfang database, was performed on dry eye parameters in the literature that featured FS-LASIK and SMILE surgery． Content analysis mainly included preoperative measurements and assessments were performed 1 week, 1 month, 3 months and 6 months postoperatively based on the Schirmer I test (SIT) without anesthesia, tear film break-up time (BUT) and the ocular surface disease index (OSDI)． RevMan 5.0 was used for statistical analysis; measurement data were statistically analyzed for curative effect with weighted mean differences (WMD) (95%CI)． A quality assessment was evaluated by the Cochrane risk assessment tools． Results A total of five articles satisfied the inclusion criteria for this study, a total of 317 cases (477 eyes): There are 235 eyes of FS-LASIK, 242 eyes of SMILE． Meta-analysis showed that there was no statistically significant difference between FS-LASIK and SMILE in patients with preoperative SIT (WMD=-0.20, 95％CI: -1.16～0.76, P>0.05) and BUT (WMD=-0.10, 95％CI: -0.88～0.68, P>0.05). One week, 1 month, 3 months and 6 months postoperatively, the SIT between FS-LASIK and SMILE was not statistically significant. However, at 1 month and 6 months postoperatively, the BUT between FS-LASIK and SMILE was statistically significant (WMD=-0.65, 95％CI: -1.10～-0.20, P<0.05; WMD=-1.09, 95％CI: -1.77～-0.40, P<0.01). Six months postoperatively, the OSDI between FS-LASIK and SMILE was statistically significant (WMD=9.18, 95％CI: 4.65～13.71, P<0.05)． Conclusion Compared with FS-LASIK, dry eye symptoms after SMILE is lighter and smaller disturbance of ocular surface.
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