Visual Quality Comparison Between ICL Implantation with Steep-Meridian Incision and FS-LASIK in Correcting Low to Moderate Astigmatism

Purpose : To compare the long-term effect and visual quality outcomes in correcting low to moderate astigmatism through implantable collamer lens implantation with steep-meridian incision (ICL-SMCI) and femtosecond laser assisted laser in situ keratomileusis (FS-LASIK). Method: Retrospective analysis of 53 eyes (41 patients, 18 to 40y) with myopic astigmatism (SE: -3.00D to -9.25D). In this study, 26 eyes were subjected to ICL-SMCI, while 27 eyes were treated with FS-LASIK. Refractive outcomes, vector analysis was evaluated preoperatively, 1 month, 6 months and 1 year postoperatively. Objective visual quality was measured at 1 year. Results: At 1 year, all the patients in both groups achieved an uncorrected distance visual acuity (UDVA) of 20/20 or better. The gain in lines of corrected distant visual acuity (CDVA) was maximum in FS-LASIK group (93%). The difference vector (DV) showed that the residual astigmatism in the FS-LASIK group was much smaller than that in the ICL-SMCI group (P<0.0001), and the correction index (CI) was significant statistical different (P<0.0001). The postoperative objective visual quality include objective scatter index(OSI)，modulation transfer function (MTF) cutoff frequency and the strehl ratio (SR) have no significant difference in two groups. Conclusions: Both ICL-SMCI and FS-LASIK effectively corrected low-to-moderate astigmatism. ICL-SMCI preserved postoperative visual quality comparable to FS-LASIK.