Application of directional customized corneal relaxing incision in EVO ICL implantation: high myopia with low astigmatism

Purpose To evaluate the efficacy of EVO-ICL implantation combined with a corneal relaxing incision for the correction of moderate to high myopia with low astigmatism. Design: prospective non-randomized clinical trial Methods This study included 35 eyes of 35 patients with astigmatism corrected by corneal relaxing incision (CRI) on the steep meridian and 30 eyes of 30 patients who underwent conventional temporal incision as controls. Visual acuity, refractive parameters, keratometry, corneal astigmatism, and corneal aberration were measured preoperatively and 1 and 3 months postoperatively. Results The refractive astigmatism of the CRI group decreased significantly from 0.89 ± 0.22 preoperatively to 0.39 ± 0.25 D at 1 month and 0.35 ± 0.30 D at 3 months postoperatively, and from 0.46 ± 0.32 D to 0.45 ± 0.34 D and 0.44 ± 0.30 D in the control group, respectively (P < 0.001). The preoperative anterior corneal astigmatism of the CRI group was significantly higher than the control group (P < 0.001) and decreased significantly from 1.03 ± 0.32 D preoperatively to 0.74 ± 0.36 D at 1 month and 0.69 ± 0.39 D at 3 months postoperatively (P < 0.001). The preoperative posterior corneal astigmatism of the CRI group decreased significantly from 0.32 ± 0.11 D preoperatively to 0.28 ± 0.12 D at 1 month and 0.25 ± 0.10 D at 3 months postoperatively (P < 0.001). There were significant differences in the postoperative RMS of trefoil aberration and total HOAs of the whole cornea, anterior cornea, and posterior cornea between the two groups (P < 0.05). Conclusion EVO-ICL implantation combined with a corneal relaxing incision to correct moderate-to-high myopia with low astigmatism is safe and effective with good short-term stability.