Effect of 2.2 mm opposite clear corneal incisions post phacoemulsification on total corneal astigmatism in a tertiary eye hospital of Eastern India

Purpose: To determine the change in total corneal astigmatism (ΔTK) in patients undergoing cataract surgery with 2.2 mm opposite clear corneal incisions (OCCIs). Design: Retrospective cohort study. Methods: This study determined the change in ΔTK in patients undergoing phacoemulsification with monofocal intraocular lens implantation with 2.2 mm OCCIs using an image-guided system over 1 month and 3 months postoperatively from 1 st January 2023 to 30 th June 2024 at a tertiary eye hospital. Manifest astigmatism and final uncorrected visual acuity (UCVA) were analyzed at the 3 rd month postoperatively. The secondary objective was to elicit the change in astigmatism from baseline to the 3 rd month in different astigmatism groups: Mild (1–1.5 diopters [D]), moderate (1.6–2 D), and severe (>2D). Results: A total of 39 eyes were included in the analysis. This study showed that 2.2 mm OCCIs significantly reduced astigmatism in mild (ΔTK: 1.22 ± 0.17–0.87 ± 0.25 D; P P st month and 3 rd month. Manifest refraction showed no significant astigmatism change at 1 month but a significant reduction occurred by 3 months. UCVA improved significantly in the mild group from 25.6% to 48.7%, achieving 0–0.2 Logarithm of the Minimum Angle of Resolution (LogMAR) by 3 months, while the moderate and severe groups showed no significant changes. Conclusion: Using a 2.2 mm keratome for the main incision as well as OCCIs during phacoemulsification stands out as a safe, effective, and notably low-cost method for correcting a mild-to-moderate degree of astigmatism.