AIM: To compare the outcomes of laser in situ keratomileusis (LASIK) performed with a femtosecond laser (Femtec, Technolas Perfect Vision GmbH, Germany) versus a mechanical microkeratome (Hansatome, Bausch and Lomb, USA) for the correction of myopia and astigmatism.METHODS: In this retrospective study, patients who had undergone LASIK using the 80-kHz Femtec femtosecond laser were compared to age- and refraction-matched patients in whom the Hansatome microkeratome was used. Refractive and visual results 1 month and 3 months postoperatively, and complication rates were compared between the two groups.RESULTS: A total of 280 eyes were analyzed (140 in each group). At 3 months postoperatively in the Femtec vs Hansatome group, spherical equivalent refraction was within ±1.00D of emmetropia in 140 vs 138 eyes (P=0.498), the cylinder was within ±0.50D in 137 vs 139 eyes (P=0.622), and the UDVA was 20/20 or better in 136 vs 137 eyes (P=0.724), respectively. There was no statistically significant difference in the complication rates between the two groups (P=0.099). CONCLUSION: LASIK performed both with Femtec femtosecond laser and Hansatome microkeratome achieved satisfactory refractive and visual results at 3 months postoperatively, without significant differences in efficacy, safety, and complication rates between the two procedures.