Nine studies of 590 patients were retrieved from the Ovid-Medline, EMBASE, Cochrane register of controlled trials and Scopus which compared femtosecond laser-assisted astigmatic keratotomy (FSAK) and toric IOL for astigmatism correction in cataract patients. The trial sequential analysis was used to collect the outcome measures of postoperative refractive cylinder, correction index, uncorrected distance visual acuity (UDVA), the percentage of patients achieving a residual refractive cylinder of 1.0 dioptre or less, target induced astigmatism (TIA), and surgically induced astigmatism (SIA). The meta-analysis showed that the toric IOLs could result in less postoperative refractive cylinders and provide better UDVA compared with that of the FSAK group. Trial sequential analysis also showed lower postoperative refractive cylinders in the toric IOL group compared with that of the FSAK group. The FSAK group showed a smaller correction index and lower mean TIA and SIA compared with toric IOLs. Neither group were associated with severe complications. The authors concluded that toric IOLs are the preferred choice for astigmatism correction in cataract patients.

