{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,27]],"date-time":"2026-02-27T07:31:03Z","timestamp":1772177463520,"version":"3.50.1"},"reference-count":21,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,2,27]],"date-time":"2026-02-27T00:00:00Z","timestamp":1772150400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>This study compared clinical outcomes of toric intraocular collamer lens (TICL) implantation for myopia and astigmatism correction using image-guided navigation versus manual astigmatic marker alignment, evaluating postoperative astigmatism correction accuracy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A retrospective analysis included 250 patients (467 eyes) undergoing TICL implantation between January and June 2023. Patients were divided into manual (slit-lamp axis marking) and image-guided (navigation-adjusted lens positioning) groups. Preoperative parameters were comparable. Postoperative visual acuity, refraction, and astigmatism vector analysis (TIA, SIA, DV, CI, AE) were assessed at 3 months.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      No significant differences were observed in preoperative parameters, postoperative spherical equivalent (SE), or corrected distance visual acuity (CDVA) (\n                      <jats:italic>P<\/jats:italic>\n                      &amp;gt; 0.05). However, sphere, cylinder, and uncorrected distance visual acuity (UDVA) differed significantly (\n                      <jats:italic>P<\/jats:italic>\n                      &amp;lt; 0.05). Vector analysis revealed no intergroup difference in target-induced astigmatism (TIA) (\n                      <jats:italic>P<\/jats:italic>\n                      &amp;gt; 0.05), but surgically induced astigmatism (SIA), absolute difference vector (DV), correction index (CI), and nd absolute Angle of Error (AE) showed significant improvements in the image-guided group (\n                      <jats:italic>P<\/jats:italic>\n                      &amp;lt; 0.05). Arithmetic AE did not differ between groups (\n                      <jats:italic>P<\/jats:italic>\n                      &amp;gt; 0.05). No intraoperative\/postoperative complications (e.g., corneal edema, iris prolapse) occurred.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Image-guided TICL implantation yielded superior visual outcomes and greater astigmatism correction accuracy compared to manual marking, with no complications reported. This highlights the clinical advantage of navigation systems in optimizing refractive precision.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fmed.2026.1672270","type":"journal-article","created":{"date-parts":[[2026,2,27]],"date-time":"2026-02-27T05:24:33Z","timestamp":1772169873000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Enhanced astigmatism correction accuracy with image-guided toric ICL implantation: a comparative clinical analysis with manual axis marking"],"prefix":"10.3389","volume":"13","author":[{"given":"Ruixia","family":"Li","sequence":"first","affiliation":[{"name":"The Graduate School of Fujian Medical University","place":["Fuzhou, China"]},{"name":"School of Medicine, Xiamen University Affiliated Xiamen Eye Center, Eye Institute of Xiamen University, Xiamen University, Xiamen","place":["Fujian, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zheng","family":"Fu","sequence":"additional","affiliation":[{"name":"The Graduate School of Fujian Medical University","place":["Fuzhou, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yang","family":"Liu","sequence":"additional","affiliation":[{"name":"The Graduate School of Fujian Medical University","place":["Fuzhou, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Caiyuan","family":"Liu","sequence":"additional","affiliation":[{"name":"School of Medicine, Xiamen University Affiliated Xiamen Eye Center, Eye Institute of Xiamen University, Xiamen University, Xiamen","place":["Fujian, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jianzhang","family":"Hu","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Fujian Medical University Union Hospital","place":["Fuzhou, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2026,2,27]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"1123","DOI":"10.18240\/ijo.2023.07.18","article-title":"Long-term observation on safety and visual quality of implantable collamer lens V4c implantation for myopia correction: a 5-year follow-up.","volume":"16","author":"Chen","year":"2023","journal-title":"Int J Ophthalmol"},{"key":"B2","doi-asserted-by":"publisher","first-page":"23","DOI":"10.1186\/s40662-021-00247-1","article-title":"Seven-year follow-up of posterior chamber phakic intraocular lens with central port design.","volume":"8","author":"Fern\u00e1ndez-Vega-Cueto","year":"2021","journal-title":"Eye Vis"},{"key":"B3","doi-asserted-by":"publisher","first-page":"1190","DOI":"10.1097\/j.jcrs.0000000000000950","article-title":"Factors leading to realignment or exchange after implantable collamer lens implantation in 10 258 eyes.","volume":"48","author":"Wei","year":"2022","journal-title":"J Cataract Refract Surg"},{"key":"B4","doi-asserted-by":"publisher","first-page":"183","DOI":"10.1177\/1120672121999991","article-title":"Astigmatism correction with toric implantable collamer lens in low and high astigmatism groups.","volume":"32","author":"Cano-Ortiz","year":"2022","journal-title":"Eur J Ophthalmol"},{"key":"B5","doi-asserted-by":"publisher","first-page":"1","DOI":"10.14744\/bej.2020.86547","article-title":"Results of callisto eye system in toric intraocular lens alignment.","volume":"5","author":"Kose","year":"2020","journal-title":"Beyoglu Eye J"},{"key":"B6","doi-asserted-by":"publisher","first-page":"1340","DOI":"10.1016\/j.jcrs.2019.03.030","article-title":"Comparative meta-analysis of toric intraocular lens alignment accuracy in cataract patients: image-guided system versus manual marking.","volume":"45","author":"Zhou","year":"2019","journal-title":"J Cataract Refract Surg"},{"key":"B7","doi-asserted-by":"publisher","first-page":"136","DOI":"10.1016\/j.jfo.2017.08.008","article-title":"[Toric lens implantation in cataract surgery: automatic versus manual horizontal axis marking, analysis of 50 cases].","volume":"41","author":"Raucau","year":"2018","journal-title":"J Fr Ophtalmol."},{"key":"B8","doi-asserted-by":"publisher","first-page":"357","DOI":"10.1080\/02713683.2022.2159981","article-title":"Comparison of visual and refractive outcome between two methods of corneal marking for toric implantable collamer lenses (TICL) in phakic eyes.","volume":"48","author":"Feldhaus","year":"2023","journal-title":"Curr Eye Res"},{"key":"B9","doi-asserted-by":"publisher","first-page":"31","DOI":"10.1016\/s0886-3350(00)00798-7","article-title":"Astigmatism analysis by the Alpins method.","volume":"27","author":"Alpins","year":"2001","journal-title":"J Cataract Refract Surg"},{"key":"B10","doi-asserted-by":"publisher","first-page":"524","DOI":"10.1016\/s0886-3350(13)80617-7","article-title":"A new method of analyzing vectors for changes in astigmatism.","volume":"19","author":"Alpins","year":"1993","journal-title":"J Cataract Refract Surg"},{"key":"B11","doi-asserted-by":"publisher","first-page":"654","DOI":"10.3928\/1081597X-20140903-01","article-title":"JRS standard for reporting astigmatism outcomes of refractive surgery.","volume":"30","author":"Reinstein","year":"2014","journal-title":"J Refract Surg"},{"key":"B12","doi-asserted-by":"publisher","first-page":"435","DOI":"10.1016\/j.jcrs.2017.04.005","article-title":"Standard for reporting refractive outcomes of intraocular lens-based refractive surgery.","volume":"43","author":"Reinstein","year":"2017","journal-title":"J Cataract Refract Surg"},{"key":"B13","doi-asserted-by":"publisher","first-page":"2969","DOI":"10.2147\/OPTH.S373378","article-title":"Low diopter phakic implantable collamer lens: refractive and visual outcomes in low myopia and myopic astigmatism.","volume":"16","author":"Alonso-Ju\u00e1rez","year":"2022","journal-title":"Clin Ophthalmol"},{"key":"B14","doi-asserted-by":"publisher","first-page":"1253","DOI":"10.2147\/OPTH.S127101","article-title":"Matched population comparison of visual outcomes and patient satisfaction between 3 modalities for the correction of low to moderate myopic astigmatism.","volume":"11","author":"Ganesh","year":"2017","journal-title":"Clin Ophthalmol"},{"key":"B15","doi-asserted-by":"publisher","first-page":"2427","DOI":"10.2147\/OPTH.S188785","article-title":"The Implantable Collamer Lens with a central port: review of the literature.","volume":"12","author":"Packer","year":"2018","journal-title":"Clin Ophthalmol"},{"key":"B16","doi-asserted-by":"publisher","DOI":"10.1177\/11206721211012861","article-title":"Posterior chamber collamer phakic intraocular lens implantation: comparison of efficacy and safety for low and moderate-to-high myopia.","author":"Pinto","year":"2021","journal-title":"Eur J Ophthalmol."},{"key":"B17","doi-asserted-by":"publisher","first-page":"1281","DOI":"10.1016\/j.jcrs.2017.07.030","article-title":"Comparison of visual outcomes, alignment accuracy, and surgical time between 2 methods of corneal marking for toric intraocular lens implantation.","volume":"43","author":"Mayer","year":"2017","journal-title":"J Cataract Refract Surg"},{"key":"B18","doi-asserted-by":"publisher","first-page":"e1","DOI":"10.1016\/j.jfo.2017.11.002","article-title":"Toric lens implantation in cataract surgery: automated versus manual horizontal axis marking, analysis of 50 cases.","volume":"41","author":"Raucau","year":"2018","journal-title":"J Fr Ophtalmol"},{"key":"B19","doi-asserted-by":"publisher","first-page":"108","DOI":"10.14744\/bej.2020.40427","article-title":"Comparison of toric intraocular lens alignment using image-guided system and manual marking technique.","volume":"5","author":"Kose","year":"2020","journal-title":"Beyoglu Eye J"},{"key":"B20","doi-asserted-by":"publisher","first-page":"969","DOI":"10.2147\/OPTH.S379856","article-title":"Intraocular implantable collamer lens with a central hole implantation: safety, efficacy, and patient outcomes.","volume":"17","author":"Wannapanich","year":"2023","journal-title":"Clin Ophthalmol"},{"key":"B21","doi-asserted-by":"publisher","first-page":"1377","DOI":"10.1007\/s00417-021-05449-w","article-title":"critical evaluation of longitudinal changes of astigmatism following implantation of toric implantable collamer lens (TICL): a comparison between treated and untreated cases over 4 years.","volume":"260","author":"Bohac","year":"2022","journal-title":"Graefes Arch Clin Exp Ophthalmol"}],"container-title":["Frontiers in Medicine"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2026.1672270\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,2,27]],"date-time":"2026-02-27T05:24:33Z","timestamp":1772169873000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2026.1672270\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,2,27]]},"references-count":21,"alternative-id":["10.3389\/fmed.2026.1672270"],"URL":"https:\/\/doi.org\/10.3389\/fmed.2026.1672270","relation":{},"ISSN":["2296-858X"],"issn-type":[{"value":"2296-858X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,2,27]]},"article-number":"1672270"}}