Visual Outcomes And Optical Quality Of Toric Implantable Collamer Lens Versus Spherical Icl With Limbal Relaxing Incisions For Low Astigmatism

To evaluate and compare the visual, refractive, and optical quality outcomes of toric implantable collamer lens (TICL) versus spherical ICL implantation combined with manual limbal relaxing incisions (ICL+LRI) for myopia with low astigmatism.

This study enrolled 48 eyes of 37 patients with low astigmatism (≤1.25 diopters [D]), undergoing either TICL (24 eyes, 18 patients) or ICL+LRI (24 eyes, 19 patients). Uncorrected and corrected distance visual acuity, manifest refraction, and higher-order aberrations (HOAs) were evaluated preoperatively and at 3 months postoperatively. Astigmatic changes were assessed via Alpins vector analysis. Subjective optical quality was evaluated using the Quality of Vision (QoV) questionnaire.

Preoperative manifest cylinder was comparable between the ICL+LRI and TICL groups (-1.03±0.21 D vs. -1.08±0.16 D; P=0.436). At the 3-month visit, residual astigmatism was significantly lower in the TICL group (-0.26±0.23 D) than the ICL+LRI group (-0.47±0.25 D; P=0.014). Alpins vector analysis revealed significant differences between groups regarding surgically induced astigmatism (ICL+LRI: 0.68±0.24 D vs. TICL: 0.97±0.23 D; P<0.001) and correction index (ICL+LRI: 0.69±0.26 vs. TICL: 0.90±0.20; P<0.001). Furthermore, 96% of eyes in the TICL group achieved an angle of error within ±15°, compared to 79% in the ICL+LRI group. No statistically significant differences existed between groups regarding objective HOAs or subjective QoV scores.