AIM: To analyze the clinical results of predictive refraction after Laser-assisted Subepithelial Keratomileusis(LASEK)in high myopia patients. METHODS: Totally, 80 patients(160 eyes)with high myopia treated by LASEK were divided into two group according to the different corneal thickness and predictive refraction. Forty patients(80 eyes)in reservation group were reserved a certain diopter(-1.00DS). Other 40 patients(80 eyes)in general group were fully corrected. Ocular symptoms, visual acuity, refraction, and intraocular pressure(IOP)was followed up and observed postoperatively and regularly.RESULTS:The postoperative visual acuity after 6 month was all the best in two groups, which appeared a slight decline 1 year and 3 years after surgery. Three years later, uncorrected visual acuity was basically stable. The preoperative refraction in two groups was -8.25±1.23D with an average of -0.75 ± 0.12D fallback. The mean corneal curvature and corneal thickness had no significantly change. IOP after surgery was stable in two groups with no complications as secondary high IOP or glaucoma, etc. The results of corneal topography indicated that keratoconus was not occurred 3 years postoperatively in two groups. Six months and 1 year after surgery, mild haze appeared in both groups which were disappeared 3 years postoperatively.CONCLUSION: On the premise of safe corneal thickness, we predict a certain degrees of myopia after LASEK in high myopia patients. Through preserving more matrix bed thickness, it will achieve the same expected effect and expand the range of correction.