Jabbour S, et al. - Researchers conducted this retrospective case series for describing three-year outcomes of spherical implantable Collamer lens (ICL) followed by excimer laser enhancement (bioptics) in eyes with high myopic astigmatism. Thirty-four cases that underwent bioptics enhancement at the Johns Hopkins Wilmer Eye Institute were analyzed. According to results, bioptics provided excellent long-term safe, predictable and successful results for high myopic astigmatism, and if toric ICL is not available, can be considered an alternative. Results indicate that wavefront-guided photoablation after phakic IOL remains an excellent choice for managing residual refractive error.