Background and Objectives: Cataract surgery is the major cause of blindness in the world. For developing countries MSICShas come in as savior simple and effective. Surgical techniques are continually modified and improved upon to decrease postoperative astigmatism. Major factor responsible is site of the cataract incision. In old age majority of the patient will have against the rule astigmatism, which worsens if the incision is taken superiorly for MSICS. The same is reduced when incicion is taken temporally. Objective: of the present study is to (a) Compare the astigmatic outcome in superior V/s temporal incision in MSICS. (b) To know the visual outcome in MSICS with both superior and temporal incision. Methods: This study has been conducted on patients of senile mature and immarute cataract admitted to ophthalmology wards in Basaveshwar Teaching and General hospital attached to M.R Medical / College, Gulbarga from November 2007 toJune 2009. Results: Inthis study with temporal sclera incision had gross lower astigmatism when compared to the patients with superor incision. The final mean of astigmation in superior sclera was 0.99 +/0.58 SD and in temporal sclera group it was 0.66 +/0.43 SD. The difference in astigmatism was highly significant, zcalculated value 4.6>2.58 tabulated Z value. Conclusion: Superior incicsion shows ATR shift as compared to temporal sclera incision which induces WTR. SAI of <1.00 D was seen in 88% of patient with temporal incision as compared to 62% in superior incision group. Temporal incision procedure less as compared to 62% in superior incision group. Temporal incision procedure less astigmation and neutralizing the preexisting.

Keywords: Cantaract Surgery; Astigmatism; Superior Incision Group.