Objective To investigate and analyze the impact of three personalized surgical design schemes for SPT trans PRK on postoperative visual quality and higher-order aberrations in individuals with myopic astigmatism， aiming to provide a foundation for more rational selection of personalized design schemes. Methods The 96 cases （96 eyes） with myopic astigmatism were divided into three groups based on three personalized design schemes and a conventional mode. Specifically， 24 eyes were assigned to the personalized group 1， which focused on coma elimination； another 24 eyes belonged to personalized group 2， where the aim was to minimize spherical aberration elimination； and the remaining 24 eyes were further categorized into personalized group 3 based on a model that aimed at minimizing spherical aberration. Additionally， there were also 24 eyes in the control group treated using the conventional mode. The study compared and analyzed various parameters including best corrected visual acuity， spherical aberration， coma， total higher-order aberration of the anterior corneal surface， as well as differences in corneal ablation thickness between personalized and conventional schemes within the surgical design software. Results （1） The postoperative visual acuity of the personalized group was significantly superior to that of the control group （P < 0.05）； （2） Among the personalized groups， Group 2 exhibited a reduced amount of corneal tissue ablation compared to other groups （P < 0.01）； （3） Group 2 demonstrated lower values than the other groups after surgery （P < 0.05）. （4） Coma： The control group showed a significantly higher level of coma compared to preoperative measurements （P < 0.01）. No significant differences were observed between Groups 1， 2， and 3 after surgery （P > 0.05）. （5） Total higher-order aberrations： All groups experienced a significant increase in total higher-order aberrations following surgery （P < 0.01）. Group 2 exhibited lower values than the other groups postoperatively （P < 0.05）. Conclusion For myopic astigmatism， SPT trans PRK incorporates the personalized surgical scheme with a focus on minimizing spherical aberration elimination mode， resulting in enhanced optimization of postoperative high-order aberration and improved visual quality， while preserving corneal tissue.