Abstract: Objective  To explore the clinical effects and the variation features of higher-order aberrations(HOAs) of femtosecond laser small incision lenticule extraction（SMILE）and implantable collamer lens （ICL） V4c  after the correction surgery of high myopia. 
Methods  The patients with -6.00 D plus high myopia who underwent myopic surgery were enrolled. In accordance with the surgical methods, they were divided into two groups, SMILE group(30 cases, 58 eyes) and ICL group(30 cases, 59 eyes), and a series of data before and after surgery, including uncorrected visual acuity(UCVA), best corrected visual acuity(BCVA), refraction, spherical equivalent(SE), intra-ocular tension and HOAs of corneas, were observed. All patients were followed up for 1 year and analyzed statistically. 
Results  As for security, the BCVA of both groups reached 20/20 plus. None eyes experienced the loss of more than one line at BCVA. As for effectiveness, at one year after the surgery, 53 eyes （91.38%） and 32 eyes （94.91%） reached 20/20 plus at UCVA in two groups respectively, and 58 eyes （100%） and 59 eyes （100%） reached 20/25 plus respectively. In terms of predictability, at one year after the surgery, the proportion of SE at ±1.0 D was 100% in both groups. The residual refractive error in SMILE group was higher than that in ICL group, and the difference between two groups was statistically significant. As for HOAs, total higher-order aberration, spherical aberration and vertical comatic aberration were increased in SMILE group after surgery. As for ICL group, the oblique trefoil was increased whilst horizonal comatic aberration was decreased. Spearman correlation analysis revealed no correlation between the aberration variation value and the preoperative spherical equivalent, cylindrical equivalent, SE, as well as the postoperative residual SE in two groups. 
Conclusion  Both SMILE and ICL have advantages of security and effectiveness for correction surgery of high myopia. ICL possessed stronger predictability for high myopia, and HOAs were not much generated.  

Key words: myopia, phakic intraocular lenses, corneal surgery, laser