Objective To evaluate patient satisfaction and visual symptoms after wavefront-guided laser in situ keratomileusis (LASIK). Methods This was a prospective, randomized, double-masked and controlled study. One hundred patients (200 eyes) who received laser in situ keratomileusis using an Allegretto Wave 1008 excimer laser system and a Moria M2 automated microkeratome were induded. The patients were randomly divided into a wavefront-guided ablation group (group A, n=46)and a standard ablation group (group S, n=54). The examinations included visual acuity and contrast sensitivity during the daytime and under low illumination, higher-order aberrations (HOA), etc.Patients were required to answer questionnaires that included reasons for surgery (8 items) and satisfaction (9 items) before surgery, and visual symptoms (18 items) 1, 3 and 6 months after surgery. The visual analog scale responses for each question were compiled for analysis as a mean score (0 to 10) and divided into 4 equal categories. The patients were followed up for 6 months.Data were analyzed with paired t test, independent t test, chi-square test and pearson correlation analysis. Results The most frequent motivating factor for surgery was to improve uncorrected visual acuity (UCVA) in group A and group S (both 100%, mean score 9.60 vs 9.56) and next was freedom from spectacles (86.9% vs 96.3%, mean score 7.98 vs 9.30). At 6 months postoperatively,responses from group A and group S were 100% and 96.3% patients, respectively (mean score, 8.67vs 8.80), indicating they were satisfied with the treatment and would recommend the operation to their friends or family members; 91.3% and 100% of the patients were satisfied with the rate of improvement, but the mean scores were significantly different (8.20 vs 8.86) (t=2.2123, P=0.0294).The percentage of visual symptoms such as glare, halo and night driving difficulty decreased after LASIK, with 4.3%, 0, 8.7% and 7.4%, 7.4%, 3.7%, respectively, in group A and group S.However, the symptoms of dry eye worsened post