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To study the effect of myopia on the pattern change in higher-order aberrations after small incision lenticule extraction.Sixty eyes of 60 patients were included: low myopia (≤−3.00 D), moderate myopia (−3.00 D to −6.00 D), and high myopia (≥−6.00 D). Total higher-order aberrations (tHOA), vertical coma (), horizontal coma (), and spherical aberration () were measured preoperatively and at postoperative 3 months.At the end of 3 months, tHOA changed significantly compared with the preoperative values (P < 0.05), except for and in the low myopia group. The change in , , and in the moderate group (−0.299, −0.175, and 0.108 μm) was 2.020, 4.861, and 4.696 times higher than the low group (−0.148, −0.036, 0.023 μm) (P = 0.002, 0.001, 0.001), respectively. The value in the high group (−0.331, −0.192, 0.154 μm) was 1.107, 1.097 (P = 0.478, 0.665), and 1.426 times (P = 0.047) higher than the moderate group. The degree of myopia was positively correlated with Δ(r = 0.447; P < 0.001) and Δ(r = 0.496; P < 0.001), and negatively correlated with ΔtHOA (r = −0.363, P = 0.004) and Δ(r = −0.599; P < 0.001).The study showed a different pattern of change in ocular aberrations after small incision lenticule extraction in patients with varying degrees of myopia. In patients with low myopia, there was no increase in or . In high myopia, however, increased with the degree of myopia, whereas the rising rate of coma was slowing.