Background: Laser vision correction has been established over the last 2 decades as a safe and effective intervention, with Laser-assisted in situ keratomileusis (LASIK), being one of the main techniques practiced globally. Femtosecond laser-assisted LASIK has become a popularized modification over the last decade and over the standard LASIK technique utilizing mechanical microkeratomes. A spherical ablation profiles performed by “wave front optimized" have been employed to reduce spherical aberration associated with myopic corrections. Aim of the Work: To evaluate the quality and efficacy of topography-guided femtosecond lasik in virgin eyes with myopia, hypermetropia and astigmatism. Patients and Methods: This comparative prospective study was conducted on 60 eyes of 30 Egyptian patients with comparing preoperative and postoperative outcomes. Eyes with myopia (-1.0 up to -8.0 diopters) or hypermetropia (+1.0 up to +5.0 diopters) or astigmatism (up to 5.0 diopters) or less. Eyes with central corneal thickness (CCT) of 500 microns or more. Eyes at risk for developing post-refractive corneal ectasia, such as keratoconus, keratoconus suspect, previous refractive surgery, corneal dystrophy, corneal guttae or opacities, any previous eye surgery e.g.:pseudophakic patients, retinal detachment surgery, all eyes were normal for example no cataract, no glaucoma, no retinal pathology and no previous trauma. Results: Our study was performed on sixty eyes of thirty Egyptian patients. Sixty eyes of thirty patients underwent LASIK using T-CAT. Seventeen patients were females and thirteen were males. The average age of the patients was 24.8 year ±5.45 standard deviation (SD). The average spherical error was -3.09 D ±2.33 SD. The average cylinder error was -1.02 D ±1.02 SD. Conclusion: The results showed that there were statistically significant differences between preoperative BCVA and postoperative UCVA with a good safety and efficacy profile with T-CAT lasik as no patient loss even one line and 80% of cases gaining at least one line postoperative.  The surgery was associated with higher values of high order aberrations after surgery than before surgery.