The study compared the results of toric intraocular collamer lens (TICL) implantation for the correction of myopia and astigmatism in 250 patients (467 eyes) using image-guided navigation versus manual axis marking. Preoperative parameters were comparable between groups. At 3 months, there were no significant differences in spherical equivalent (SE) or corrected distance visual acuity (CDVA) (P > 0.05). However, sphere, cylinder, and uncorrected distance visual acuity (UDVA) were significantly different (P < 0.05). Vector analysis showed significant improvements in surgically induced astigmatism (SIA), absolute difference vector (DV), correction index (CI), and absolute angle of error (AE) in the image-guided group (P < 0.05), with no differences in target astigmatism (TIA) or arithmetic AE (P > 0.05). There were no intraoperative or postoperative complications, such as corneal edema or iris prolapse. Image-guided TICL implantation achieved greater accuracy in astigmatism correction compared to the manual method.