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The femtosecond laser has a number of advantages,.such as short pulse time,.high instantaneous power,.high repetition rate, low monopulse energy, and small thermal effect. Fem-tosecond laser-assisted small incision lenticule extraction (SMILE) is becoming the new direction in refractive surgery, and the ocular surface changes after SMILE are attracting in-creasingly more attention. This article reviews adverse effects, including dry eye, injury of corneal nerves, and ocular sur-face inflammation,.occurring after SMILE.