Toric versus Non-toric Implantable Collamer Lens Implantation for Low Myopic Astigmatism: 12-month Follow-up

Background: Implantable collamer lens (ICL) implantation and toric implantable collamer lens (TICL) have shown effectiveness for myopic and astigmatic patients. This study aims to evaluate and compare the visual and refractive outcomes of TICL and ICL implantation in patients with low myopic astigmatism. Methods: This retrospective study included 64 eyes of 64 patients with low myopic astigmatism who underwent TICL or ICL implantation. Visual acuity, refractive outcomes, visual quality, and ocular parameters were assessed at baseline, 3 months, and 12 months postoperatively. The surgical results were evaluated using statistical and astigmatism vector analysis methods. Results: The safety index was 1.24 ± 0.17 for TICL and 1.21 ± 0.17 for ICL (p = 0.534). The efficacy index was 1.19 ± 0.18 for TICL and 1.07 ± 0.16 for ICL (p = 0.003). The uncorrected visual acuity at 12 months was -0.07 ± 0.06 in the TICL group and -0.02 ± 0.07 in the ICL group, respectively (p = 0.006). The postoperative astigmatism was -0.05 ± 0.18 D in the TICL group, and -0.44 ± 0.38 D in the ICL group (p﹤0.001). Both groups exhibited good predictability (R²﹥0.94) and long-term stability for postoperative refraction, as well as a significant increase in visual quality (p﹤0.001). The correction index was 0.91 and 0.69 in the TICL and ICL groups, respectively. Conclusions: TICL and ICL demonstrated favorable safety, predictability, and comparable improvement in visual quality for low astigmatic patients in the long term. Nevertheless, compared to ICL, TICL presented superior efficacy, stability, postoperative visual acuity, as well as better astigmatism correcting outcomes.