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Abstract
Improving the refractive state of the eye following cataract surgery is now part of gold standard related to the outcome of such surgery. Astigmatic correction is still a somewhat unsettled issue with different options proposed, each having its pros and cons. In this study, the correction of pre-existing astigmatism during phacoemulsification was studied in 160 patients. Placing the incision on the steep axis was done in 58 patients according to topography, and this was-compared to 61 controls where the incision was off axis. Three patients had limbal relaxing incisions. Results showed that placing the 3.5 to 4 mm self sealing incisions on the steep corneal meridian effectively decreases topographic astigmatism by a mean vector change of 0.95 +/-0.53D and a mean scalar decrease of 0.37 +/-0.62D. It was also found that if incisions are not placed on the steep axis, astigmatism would increase by a mean vector of 0.62 +/-0.40D and a mean scalar increase of 0.27 +/-0.35D. So, placing the incision on the steep corneal axis is a safe easy effective and simple means which could be employed to decrease pre-existing astigmatism within the range described