AIM: To evaluate the clinical effect of toric implantable collamer lens(TICL)V4c for correcting moderate to high myopia with high astigmatism using vector analysis and quality of life impact of refractive correction(QIRC).

METHODS: Retrospective case series. A total of 55 patients(90 eyes)with moderate to high myopia and high astigmatism who received TICL V4c implantation in the refraction surgery center of ophthalmology department in our hospital from January 2019 to December 2022 were collected. Followed-up for 1 a, the uncorrected distance visual acuity(UDVA), best corrected visual acuity(BCVA)and diopters were observed. Alpins vector analysis was used to evaluate the effect of astigmatism correction, and QIRC scale was used to evaluate patients' quality of life.

RESULTS: At 1 a postoperatively, the UDVA of 98% eyes was the same or better than pre-operative BCVA, the safety index was 1.11±0.14, and the efficacy index was 1.11±0.15. The angle of error of 97% of the astigmatic eyes was within ±15°. The results of vector analysis showed that correction index was 0.83±0.13, angle of error was 1.00±4.49°, and index of success was 0.21±0.15. The total higher order aberrations under a pupil diameter of 6 mm was significantly increased compared with preoperatively(P<0.05), the QIRC score was significantly better than that before surgery(P<0.001), and the increase of total QIRC scores was positively correlated with preoperative spherical equivalent(r_s=0.215, P<0.05), indicating that the higher degree of myopia before surgery the patients, the better the quality of life after TICL implantation.

CONCLUSION: TICL V4c implantation for the correction of moderate to high myopia with high astigmatism is safe and effective, and the patients' quality of life significantly improved after surgery.