Objective To study the influence of high intraocular pressure （IOP） on visual quality after excimer laser corneal refractive surgery. Methods This was a prospective， observational study. The experimental group included 68 eyes of 41 patients with high IOP after corneal excimer laser refractive surgery， and the normal group included 68 eyes of 41 patients with normal IOP. Measurements included visual acuity， corrected spherical lens， corrected cylindrical lens， corneal aberrations （C7， C8， C12）， corneal thickness， corneal anterior surface curvature and corneal posterior surface elevation， contrast sensitivity and a record of subjective feelings at 1 week and 2 weeks after surgery. The differences between the groups were evaluated with a independent t test and a paired t test. Reports of subjective feelings were analyzed with a chi-square test， and a Wilcoxon test was used to analyze the abnormal distribution data. Results One week after surgery， visual acuity （t=-2.43， Ｐ<0.05）， corrected spherical lens （t=-2.96， Ｐ<0.05）， and contrast sensitivity （12 c/d） （t=-0.33， Ｐ<0.05） in the experimental group were lower than in the normal group， but C7 （t=-0.19， Ｐ<0.05） and C12 （t=5.08， Ｐ<0.05） were higher. The differences were statistically significant. In the experimental group， visual acuity （t=-3.66， Ｐ<0.05）， corrected spherical lens （t=-4.38， Ｐ<0.05）， and contrast sensitivity （12 c/d） （t=-0.32， Ｐ<0.05） were lower 1 week after surgery than at 2 weeks after surgery， but C7 （t=-0.17， Ｐ<0.05） and C12 （t=5.33， Ｐ<0.05） were higher. The differences were statistically significant. Conclusion After excimer laser corneal refractive surgery， high intraocular pressure can lead to curvature of the corneal anterior surface， aberrations and refractive changes， and lead to a decline in visual quality.