In recent years, corneal and lens refractive surgery has increasingly replaced traditional frames and corneal contact lenses to correct refractive errors, and its efficacy has been recognized by both physicians and patients. However, with the development of refractive surgery, more and more doctors are realizing that this type of surgery, while improving vision, also brings a series of visual quality problems, such as reduced contrast sensitivity and nighttime glare, which also makes some patients report that they can see, but not clearly and uncomfortably, after surgery. Over the past two decades, myopic refractive surgery methods have gone through RK, clear lens removal, superficial cutting PRK, LASIK to today’s optimized superficial cutting LASEK/epi-LASIK and femtosecond LASIK, full femtosecond (FLEX, SMILE, etc.), and IOL implantation for crystalline eyes. Numerous studies have shown that refractive surgery can increase the higher-order aberration of the eye, which reflects the imperfection of the visual refractive system of the human eye, and that postoperative higher-order aberration changes are one of the main reasons affecting the visual quality after refractive surgery, which comes from the preoperative aberration, the intraoperative aberration and the healing process of corneal repair. At present, it is believed that while changing the shape of the anterior corneal surface, correcting low order aberrations such as out-of-focus (myopia and hyperopia) and astigmatism, and improving the patient’s naked eye visual acuity, it causes an increase in higher order aberrations, which is the main cause of glare, halos and night vision loss, especially in the dark environment where the aberration increases with the increase of the pupil. Visual acuity is a reflection of the human eye’s ability to distinguish objects with high contrast and clear boundaries. In daily life, we also need to recognize many objects with blurred boundaries, which is evaluated by contrast sensitivity. Decreased contrast sensitivity is another important reason for decreased visual quality such as night vision, halos and asterisms. In order to minimize the loss of visual quality after refractive surgery, a systematic preoperative evaluation is essential. In addition to routine primary optometry, etc., systematic measurements of dark pupil diameter, higher order aberrations, contrast sensitivity and corneal topography are required. For a small number of patients with high preoperative higher-order aberrations and irregular corneal surface, appropriate use of aberration-guided or corneal topography-guided excimer laser surgery and appropriate increase in the cutting range according to the dark pupil diameter can significantly reduce postoperative night vision loss, glare and other uncomfortable symptoms. It is believed that as medical research continues to advance and surgical methods continue to improve, the quality of vision after refractive surgery will come more and more, allowing our patients to see more clearly and look further!