To compare the corneal astigmatic outcomes of phacoemulsification cataract surgery with different incision site in patients with low with the rule (WTR) corneal astigmatism.

In this randomized prospective study, we included 93 eyes of 74 patients with corneal WTR astigmatism less than 1.50 diopter. All patients underwent phacoemulsification and implantation of a hydrophobic acrylic foldable intraocular lens with different incision sites, group A through steep corneal meridian incision, group B through an oblique clear corneal incision and group C through a temporal clear corneal incision. Preoperative keratometric data were compared with data collected 3 months postoperatively. Vector analysis method was used to calculate the surgical induced astigmatism (SIA).

Mean preoperative keratometric astigmatism was 0.79 ± 0.28D, 0.76 ± 0.43D and 0.73± 0.45D in the steep, oblique and temporal incision groups respectively. Mean keratometric astigmatism was 0.61±0.31D, 0.58 ± 0.38D and 0.7 ± 0.3D at 3 months after surgery in the Steep, oblique and temporal groups respectively. SIA at the same follow-up interval was 1.05 ± 0.56 D, 0.96 ± 0.68D and 1.08 ± 0.63 D Steep, oblique and temporal incision groups respectively.

In the patient with WTR corneal astigmatism under 1.5 diopter; there is not any statistically significant difference in corneal astigmatism changes and surgical induced astigmatism between Steep, oblique and temporal incision groups