To compare the visual and refractive outcomes of wavefront-optimized (WFO) ablations (wavelight allegretto) and wavefront-guided (WFG) ablations (VISX Custom Vue). Overall, two consecutive groups of eyes were treated for myopia and myopic astigmatism with laser in-situ keratomileusis. One group was treated with WFO ablation and the other group was treated with WFG ablation. Preoperative and 1, 3 and 6 months postoperative refractive evaluation (efficacy, safety, predictability, accuracy, stability, and refractive astigmatism), higher order aberrations (HOAs), and contrast sensitivity were analyzed. The WFO group comprised 20 eyes of 11 patients and the WFG group comprised 34 eyes of 17 patients. Postoperatively, the mean refractive spherical equivalent was −0.21±0.30 D in WFO group and −0.23D±0.57 D in WFG group. The mean values for postoperative uncorrected distance visual acuity were 0.93±0.15 and 0.96±0.16 in WFO and WFG groups, respectively. Safety index was 1.11 in WFO group and 1.17 in WFG group. Six months postoperatively, in WFO group, the induced HOA root mean square (RMS) was 0.25±0.21 μm (=0.007), induced coma RMS was 0.07±0.23 μm (=0.84), and induced spherical aberration RMS was 0.03±0.12 μm (=0.467), whereas induced trefoil RMS was −0.09±0.23 μm (=0.003). In WFG group, induced HOA RMS was 0.9±0.11 μm (=0.002), induced coma RMS was 0.01±0.30 μm (=0.065), and induced spherical aberration RMS was 0.09±0.17 μm (=0.214), whereas induced trefoil RMS was 0.04±0.15 μm (=0.005). Contrast sensitivity testing showed a statistically significant improvement in both groups at low spatial frequencies test. Both WFG and WFO showed comparable accuracy, efficacy, and safety with nearly equal induction of all HOA.