Background and aim: The aim of this work was to compare the refractive outcomes between topography-guided LASIK with measured astigmatism on the Wave-Light Contoura software and clinically measured astigmatism in eyes with primary myopia and myopic astigmatism.

Subjects and methods: This study is designed as a Retrospective Cohort Study. The study met the criteria of the Research Ethics committee (REC) with approval No. of Ms 4-4-2020 in Research setting Ebsar eye center between 2019 and 2020. Sixty eyes were selected from patients already had Topoguided-LASIK treatments for myopia and myopic astigmatism. The study included males and females, aged 18 to 45 years old and they were divided into two groups, one group was corrected with Topoguided-LASIK using clinical astigmatism and the other group was corrected using measured astigmatism provided by the software.

Data Synthesis: The Chi-square test, Mann–Whitney U test and Generalized Linear Mixed Model were utilized for the analysis in the current study.

Results: There was statistically non-significant difference between the studied groups regarding mean K measurement preoperatively and at 1, 3, 6 and 12 months postoperatively. There is statistically significant change over time in each group. There was statistically non-significant difference between the studied groups regarding pachymetry preoperatively and at 1, 3, 6 and 12 months postoperatively. There is statistically significant change over time in each group.

Conclusion: topography-guided LASIK with the Contoura system was associated with less induction of HOAs with similar refractive and visual outcomes in clinical refraction.

Keywords: Topography-guided LASIK, Corneal topography, astigmatism, Myopia.