Comparison Between TICL and ICL+AK for High Myopic Astigmatism

Inclusion Criteria: * age ranged from 18 to 40 years, * myopia greater than -8.00 diopters (D), and refractive cylinder in the range of 1.50D to 5.50D, * for the patients who were planned to undergo AK+ICL implantation, the axial difference between the corneal astigmatism and the manifest refractive astigmatism was less than 10 degree, * a stable refractive error during the previous 2 years, * anterior chamber depth more than 2.8 mm, * endothelial cell density (ECD) more than 2500 cells/mm2, and * scotopic pupillary diameter less than 7 mm. Exclusion Criteria: * subjects had significant irregular astigmatism, corneal pathological changes, glaucoma, ocular inflammation, or previous ocular trauma or surgery.