AIM:To evaluate the clinical efficacy of TOSCA treatment of complex refractive errors. METHODS:Totally 59 patients 113 eyes who received TOSCA were selected.There were complex refractive errors,such as 67 eyes of the high degree of corneal thickness comparative thin,8 eyes of irregular corneal shapes,33 eyes of corneal astigmatism large,6 eyes of eccentric ablation after PRK/LASIK,5 eyes of re-myopia after PRK/LASIK.The spherical equivalent degree was -1.25 - -13.88D with an average of -6.87±2.86D.The uncorrected visual acuity(UCVA),best-corrected visual acuity(BCVA),spherical equivalent,keratomrtry of corneal curvature,the thickness of corneal,wavefront aberration and eccentric ablation were evaluated postoperatively. RESULTS:The UCVA was 0.13±0.12 preoperatively and 0.94±0.22 6 months postoperatively,there was statistical difference(P<0.05).The average spherical equivalent was -0.45±0.48D6 months postoperatively,it was within±0.5D.The preoperative keratomrtry of corneal curvature was 43.01±1.56D,and 37.99±1.69D 6 months postoperatively,there was statistical difference(P<0.05) between preoperation and postoperation.The preoperative average cutting thickness was 88.30±28.86μm and 117.93±32.72μm in LASIK/LASEK,the former saved about 27.77±23.24μm,there was no statistical difference between two groups(P<0.05).The total high order aberration,the level of coma,vertical coma and spherical aberration were 0.50±0.23,0.10±0.08,0.14±0.12,0.12±0.09 preoperatively,and 0.68±0.25,0.21±0.22,0.32±0.18,0.38±0.14 6 months postoperativly,there was statistical differen between them(P<0.05).The eccentric ablation of 6 eyes was more than 1.0mm with an average of 1.33±0.45mm because of PRK/LASIK preoperatively, its average was 0.49±0.22mm postoperatively,there was statistical difference between preoperation and postoperation (P<0.05). CONCLUSION:In the treatment of complex refractive errors,TOSCA have better safety,effectiveness and predictability,and can save corneal thickness significantly to some extent.