To study theeffect of micro incision (1.8 mm) and small incision (2.2 mm and 2.8 mm) coaxial phacoemulsification on surgically induced astigmatism (SIA) and high-order aberrations (HOA) of anterior and posterior corneal surface.

The present randomized clinical study included 32 eyes having a 1.8-mm, 38 eyes having a 2.2-mm, and 30 eyes having a 2.8-mm corneal incision. SIAs were measured at 1 and 3 months postoperatively. HOAs included coma, trefoil, and spherical aberration. The coma-root mean square (RMS) and trefoil-RMS were evaluated at 1 month after the cataract operation.

Surgically induced astigmatisms were 0.41 ± 0.30 diopter (D) in the 1.8-mm incision group, 0.47 ± 0.21 D in 2.2-mm group and 0.71 ± 0.50 D in the 2.8-mm group. The SIA of the 1.8-mm group was smaller than the other groups ( p = 0.002). There was no statistically significant difference in coma, spherical aberration of the corneal anterior surface and trefoil, or spherical aberration of the posterior surface among the 3 groups at 1 month after surgery.

Incision size contributes to postoperative corneal astigmatism. Phacoemulsification cataract surgery with less than 2.8-mm incision does not significantly influence the corneal aberrationsof anterior and posterior corneal surfaces.