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The purpose of this study was to compare the clinical outcomes and corneal biomechanical changes between 120-µm and 140-µm cap thickness after small incision lenticule extraction (SMILE). This prospective study included 150 eyes (150 patients 91 eyes in the 120-µm group, and 59 eyes in the 140-µm group) who underwent SMILE. Enhanced correction nomograms were applied for patients according to cap thickness. Clinical outcomes, including visual acuity, refraction, and corneal wavefront aberrations, were compared between the two groups. Corn