Objective  To investigate changes in tear dynamics and corneal sub-basal nerve fiber regeneration after laser in situ keratomileusis （LASIK） surgery  with a femtosecond laser and a mechanical microkeratome. Methods  In a prospective case-control study， 40 eyes of 20 patients were treated with FEMTO LDV femtosecond laser LASIK surgery （F-LASIK group） or mechanical microkeratome LASIK surgery （M-LASIK group） respectively. Tear film break-up time （BUT）， Schirmer I test with corneal fluorescein staining （FS） and in vivo confocal microscopy of corneal subbasal nerve fibers （CSNFs） were obtained preoperatively and 1 and 3 months after surgery. Images of the CSNFs were analyzed to evaluate nerve regeneration. Data were analyzed using repeated measures ANOVA， an independent samples t test， Mann-Whitney U test and Spearman correlation analysis. Results  At 1 and 3 months after operation the average of BUT of F-LASIK group was significantly longer than that of M-LASIK group （t=-2.195， -2.174， P<0.05）. Schirmer I test results and the FS were comparable between the 2 groups. The nerve regeneration score was a little higher in F-LASIK group （1.03±0.63） than that in M-LASIK group （0.83±0.55） at 1 month after surgery， but there was no significant difference （Z=-1.400， P>0.05）. The nerve regeneration score in F-LASIK group （2.31±0.83） was significantly higher than that in M-LASIK group （1.93±0.80） at 3 months after surgery （Z=-2.100， P<0.05）. Significant positive correlations were found between Schirmer I test and the CSNFs regeneration score （r=0.231， P<0.01）， while there was no statistically significant associations between the CSNFs regeneration score and BUT （r=0.143， P>0.05） or FS （r=-0.049， P>0.05）. Conclusion  The recovery of tear dynamics and corneal subbasal nerve fibers is faster in FEMTO LDV LASIK than in traditional LASIK. Schirmer I test is increase with the CSNFs regeneration.