Changes in higher-order aberrations: toric implantable collamer lens implantation versus ICL combined with limbal relaxing incision

Purpose: To compare the safety, efficacy and changes in corneal aberrations between Implantable Collamer Lens (ICL) combined with Limbal Relaxing Incision (LRI) and Toric ICL (TICL) implantation for moderate astigmatism (1.00-1.75 D). Methods: A retrospective study included 30 subjects (46 eyes) assigned to ICL combined with LRI (23 eyes) or TICL (23 eyes) group. Uncorrected distance visual acuity (UDVA), objective refraction, astigmatism vector analysis were assessed preoperatively and at 1 week, 1 month and 3 months postoperatively; corneal aberrations were compared preoperatively and 3 months postoperatively. Results: Both groups showed comparable outcomes in visual acuity, refraction postoperatively. Surgically Induced Astigmatism (SIA) showed a decreasing trend in the LRI group (1.07 to 0.92, P = 0.044), while it remained stable in the TICL group (1.11 to 1.20, P = 0.507). Total corneal wavefront aberrations, spherical aberration and horizontal coma postoperatively showed reduction in LRI group, whereas slightly increased in the TICL group (all P< 0.05). Conclusion: Both ICL combined with LRI and TICL implantation achieve good efficacy in correcting moderate astigmatism. The TICL group showed better postoperative astigmatism stability. The LRI group demonstrated reductions in several corneal aberration parameters compared with the TICL group.