AIM: To explore the clinical efficacy of the myopic with moderate to high astigmatism correction between corneal topography-guided femtosecond laser in situ keratomileusis(FS-LAISK)and Toric implantable collamer lens(TICL).

METHODS: A total of 60 patients(115 eyes)with moderate to high astigmatism in myopia(115 eyes)from June 2019 to June 2021 and treated in the refractive center of Heyuan Aier Eye Hospital were enrolled in the study, then were divided into Group A and Group B according to the operations they would accept. There were 32 patients(62 eyes)in the Group A treated with corneal topography-guided FS-LASIK and 28 patients(53 eyes)in the Group B treated with TICL implantation. Uncorrected visual acuity(UCVA), best corrected visual acuity(BCVA), spherical diopter and residual astigmatism were recorded preoperatively and postoperatively at 3mo, surgical safety and efficacy were evaluated, and the Alpins vector analysis was used to evaluate the astigmatism.

RESULTS: The postoperative at 3mo, there were no differences in the safety index(1.163±0.167 vs 1.136±0.194)and the efficacy index(1.145±0.159 vs 1.123±0.196)between the patients of the two groups(P>0.05). However, the astigmatism vector analysis showed that there were statistically differences in the index of success index \〖0.125(0.091, 0.200)vs 0.200(0.167, 0.250)\〗, the correction index \〖1.000(0.902, 1.066)vs 0.834(0.783, 0.869)\〗 and the flattening index \〖1.000(0.922, 1.079)vs 0.835(0.795, 0.870)\〗(P<0.01).

CONCLUSION:Corneal topography-guided FS-LASIK and TICL implantation were effective and safe in correcting myopia with moderate to high astigmatism, and corneal topography-guided FS-LASIK perform better than TICL implantation for the astigmatism correction.