Abstract: Higher-order aberrations are closely related to visual quality. Higher-order aberrations before and after corneal refractive surgery are related to various factors such as patient congenital factors, intraoperative patient cooperation, surgical plan selection, and postoperative corneal healing response. Improving patient examination before surgery, providing personalized design plans, maintaining good fixation and positioning during surgery, improving and updating surgical equipment, rational postoperative medication, and reducing postoperative complications are all important for reducing postoperative higher-order aberrations. This article describes the common factors that affect higher-order aberrations before and after surgery and the progress of research on higher-order aberrations and visual quality, with the aim of reducing the induction of higher-order aberrations and providing new research ideas for improving the accuracy and personalisation of corneal refractive surgery. (Int Rev Ophthalmol, 2023, 47: 269-275)

Key words: refractive surgery, higher-order aberration, visual quality