Abstract
Objective: Globally a significant proportion of treatable blindness is caused by cataract, especially in India and southeast Asia. Treatment of cataract is surgical correction with intraocular lens implantation. The main drawback of surgical correction is induction of postoperative astigmatism in patients. The aim of this study was to compare the degree of astigmatism in manual small incision cataract surgery and phacoemulsification 3 mo postoperatively
 Methods: The study was a retrospective case study on postoperative corneal astigmatism after cataract surgery. It was conducted in a tertiary care hospital in Thandalam, Tamil Nadu. A total of 100 patients were selected and divided into two groups, group A (=50) underwent phacoemulsification and group B (=50) underwent manual small incision cataract surgery. Preoperative astigmatic status of the patients was noted from patient records. Both groups were evaluated 3 mo postoperatively using automated keratometry. The data collected was analyzed using Microsoft Excel Independent T test, p<0.05 was considered statistically significant. Power of the study was 80% with an alpha error of 5%.
 Results: Mean postoperative astigmatism at 3 mo was 0.91±0.255D and 0.34±0.110D due to manual small incision cataract surgery and phacoemulsification, respectively.
 Conclusion: Postoperative astigmatism was greater in manual small incision cataract surgery than phacoemulsification. Improvement in preoperative astigmatism was seen in patients who underwent superotemporal incision phacoemulsification
Highlights
In India, cataract accounts for 62.6% of blindness, followed by uncorrected refractive errors (19.7%), glaucoma (5.8%) and surgical complications (1.2%)
Postoperative astigmatism was greater in manual small incision cataract surgery than phacoemulsification
Improvement in preoperative astigmatism was seen in patients who underwent superotemporal incision phacoemulsification
Summary
In India, cataract accounts for 62.6% of blindness, followed by uncorrected refractive errors (19.7%), glaucoma (5.8%) and surgical complications (1.2%). A 2002 study estimated 3.8 million Indians go blind from cataract per year [1]. Indian eye camps provide manual small incision surgery, a faster, low-cost alternative to phacoemulsification. In 2012, India achieved a cataract surgical rate of 6000 [2]. During 2016-2017, 64,81,435 cataract surgeries were performed with 95% IOL implantation [3]. The drawback of MSICS is significant postoperative corneal astigmatism. Postoperative astigmatism depends on incision size, shape, site of incision and preoperative astigmatism [4]
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