Corneal high-order aberrations did not differ between bladeless or microkeratome flap creation at any examination before or after LASIK (n=21 at every examination, paired analysis). Total high-order aberrations increased immediately after LASIK and remained elevated through 36 months in both groups, except for the 4 mm pupil in the bladeless group (minimum detectable difference between 36 months and preoperative in the bladeless group was 0.06 µm [α=0.05/5, β=0.20, n=21, paired analysis]).