Purpose.To compare dry eye disease following SMILE versus FS-LASIK.Design.Prospective, nonrandomised, observational study.Patients.90 patients undergoing refractive surgery for myopia were included. 47 eyes underwent SMILE and 43 eyes underwent FS-LASIK.Methods.Evaluation of dry eye disease was conducted preoperatively and at 1, 3, 6, and 12 months postoperatively, using the Salisbury Eye Evaluation Questionnaire (SEEQ) and TBUT.Results.TBUT reduced following SMILE at 1 and 3 months (p<0.001) and at 1, 3, and 6 months following FS-LASIK (p<0.001). TBUT was greater following SMILE than FS-LASIK at 3, 6, and 12 months (p<0.001,p<0.001, andp=0.009, resp.). SEEQ scores increased (greater symptoms) following SMILE at 1 month (p<0.001) and 3 months (p=0.003) and at 1, 3, and 6 months following FS-LASIK (p<0.001). SMILE produced lower SEEQ scores (fewer symptoms) than FS-LASIK at 1, 3, and 6 months (p<0.001).Conclusion.SMILE produces less dry eye disease than FS-LASIK at 6 months postoperatively but demonstrates similar degrees of dry eye disease at 12 months.