Comparison of femtosecond laser-assisted corneal relaxing incisions and toric implantable collamer lens for low-to-moderate astigmatism: A retrospective study

To compare the clinical efficacy of femtosecond laser-assisted corneal relaxing incisions (FS-CRI) with that of toric implantable collamer lens (TICL) for low-to-moderate astigmatism. This Retrospective study included patients with regular astigmatism ranging from 0.75 D to 2.25 D who underwent FS-CRI combined with implantable collamer lens (ICL) implantation or TICL implantation alone at Beijing Aier-Intech Eye Hospital between March 2020 and December 2021. FS-CRI were made using the LenSX platform (Alcon Laboratories, Inc). Study parameters included uncorrected (UDVA) and corrected (CDVA) distance visual acuity, refractive astigmatism, total wavefront aberration and retinal image quality parameters, and any surgery-related complications. Vector analysis of astigmatism was performed using the Alpins method. The FS-CRI and TICL group included 35 (56 eyes) and 36 (55 eyes) patients, respectively. There was no significant between-group in the proportion of UDVA reaching 20/20 at 3 months postoperatively (FS-CRI group: 98% and vs. TICL group: 100%). Both groups achieved comparable postoperative residual refractive astigmatism, and the mean correction index was 0.80 in FS-CRI group and 0.82 in TICL group. The total spherical aberration, coma, and high-order aberration were comparable between the two groups, but the postoperative total trefoil was significantly higher in the FS-CRI group (P = 0.022). There was also no significant between-group difference in retinal image quality parameters. FS-CRI combined with ICL implantation can achieve similar astigmatism correction efficacy and postoperative visual quality to TICL implantation.