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Methods: Patients who underwent myopia correction using either VisuMax 500 (493 eyes of 249 patients) or VisuMax 800 (169 eyes of 85 patients) employing the nomogram of VisuMax 500 were enrolled in this retrospective case\u2013control study. At 2 months after the operation, the percentage of eyes achieving a postoperative uncorrected distance visual acuity (UDVA) of 20\/20 and residual refractive error were compared between the two groups. Additionally, the percentage of eyes with refractive astigmatism angle of error within \u00b115\u00b0 and the mean absolute angle of error were analyzed. Results: In the VisuMax 500 and 800 groups, 99% and 97% of eyes achieved a postoperative UDVA of 20\/20, respectively. Postoperative residual astigmatism was similar between the two groups, but residual myopia was significantly lower in the VisuMax 800 group (\u22120.09 \u00b1 0.50 cylinder diopters [CD]) compared to the VisuMax 500 group (\u22120.21 \u00b1 0.49 CD; p-value = 0.005). Additionally, 84% of eyes in the VisuMax 800 group achieved astigmatism correction within \u00b115\u00b0 of the intended meridian, significantly outperforming the 71% in the VisuMax 500 group (p-value = 0.002), with a significantly smaller mean absolute angle of error (8.3 \u00b1 12.2\u00b0 and 14.1 \u00b1 20.1\u00b0; p-value &lt; 0.001). Conclusions: Both VisuMax 500 and VisuMax 800 effectively corrected myopia. However, in terms of the accuracy of astigmatism axis correction, VisuMax 800 demonstrated superior precision compared to VisuMax 500. This study may be limited by perceived bias associated with evaluating two platforms from the same manufacturer.<\/jats:p>","DOI":"10.3390\/diagnostics15192450","type":"journal-article","created":{"date-parts":[[2025,9,25]],"date-time":"2025-09-25T12:05:13Z","timestamp":1758801913000},"page":"2450","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Comparison of Refractive Outcomes Between Small Lenticule Extraction Using a 500 KHz and a 2 MHz Femtosecond Laser"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8558-4313","authenticated-orcid":false,"given":"Jung Wan","family":"Kim","sequence":"first","affiliation":[{"name":"BGN Jamsil Lotte Tower Eye Clinic, Seoul 05510, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9475-4409","authenticated-orcid":false,"given":"Youngsub","family":"Eom","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Korea University Ansan Hospital, Ansan 15355, Republic of Korea"},{"name":"Department of Ophthalmology, Korea University College of Medicine, Seoul 02841, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3985-990X","authenticated-orcid":false,"given":"Dong Hyun","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Korea University College of Medicine, Seoul 02841, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ji Won","family":"Jeong","sequence":"additional","affiliation":[{"name":"BGN Jamsil Lotte Tower Eye Clinic, Seoul 05510, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seh Kwang","family":"Park","sequence":"additional","affiliation":[{"name":"BGN Jamsil Lotte Tower Eye Clinic, Seoul 05510, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jong Suk","family":"Song","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Korea University College of Medicine, Seoul 02841, Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,9,25]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"335","DOI":"10.1136\/bjo.2009.174284","article-title":"Small incision corneal refractive surgery using the small incision lenticule extraction (SMILE) procedure for the correction of myopia and myopic astigmatism: Results of a 6 month prospective study","volume":"95","author":"Sekundo","year":"2011","journal-title":"Br. 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