Objective To investigate the changes in tear film and ocular surface after epipolis laser in situ keratomileusis (Epi-LASIK), and to evaluate the relationship with haze and refractive regression. Methods Epi-LASIK was performed on 214 eyes with low and moderate myopia and 154 eyes with high myopia. Tear film break up time (BUT), Schirmer Ⅰ test and corneal fluorescence staining were observed before and after the operation. Corneal haze and refractive regression were also examined. The results were analyzed with t test and correlation analysis. Results Haze was found in 87 eyes (23.6%) 1 month after the operation, in 69 eyes (18.8%) 3 months after the operation, and in 48 eyes (13.0%) 6 months after the operation. Refractive regression was found in 37 eyes (10.1%) 6 months after the operation. Haze and refractive regression were only found in high myopia. The values of BUT decreased in all eyes after Epi-LASIK. There was a significant decrease in eyes with high myopia 1 month, 3 months and 6 months after the operation (t=6.82, 7.51,6.73, P＜0.05). The Schirmer Ⅰ test showed no differences when all eyes were compared before and after the operation, and there were no differences between the two groups after the operation (P＞0.05). There was more fluorescence staining on the corneas of eyes with high myopia compared to eyes with low and moderate myopia (t=5.48, 5.23, 7.67, P＜0.05). There was a positive correlation between the occurrence of haze and a decrease in the scope of BUT (r=0.892), and there was a positive correlation between the occurrence of haze and the amount of fluorescence staining on the cornea after the operation (r=0.881). There was a greater decrease in tear film stability in eyes with refractive regression 6 months after the operation (t=5.50, P＜0.05). Theamount of fluorescence staining on the cornea was also greater in eyes with refractive regression 6 months after the operation (t=5.27, P＜0.05). Conclusion The changes in tear film and the ocular surface are associated with haze and refractive reg