The type of incision is the major contributory factor to the postoperative astigmatism. Different incisions may cause different degrees of astigmatism. It becomes imperative to compare the SIA caused by the commonly used incisions like straight and frown incisions. Objectives: To evaluate and document the best corrected visual acuity and surgically induced astigmatism in patients undergoing manual small incision cataract surgery by straight incision and frown incision. To compare the surgically induced astigmatism following straight and frown incision. Materials and Methods: For this prospective study a total of 96 eyes fulfilling the inclusion criteria were selected and allotted into two groups by simple randomization technique. Group1 – 48 patients – underwent MSICS with straight incision. Group2 – 48 patients – underwent MSICS with frown incision. This study was conducted in the
department of ophthalmology at R. L. Jalappa Hospital and Research, Kolar attached to Sri Devaraj Urs Medical College, between January 2018 and May 2019. Post-operative visual acuity was assessed with Snellen’s chart. surgically induced astigmatism was calculated using SIA calculator version 2.1. Results: The uncorrected visual acuity of group 2 was better when compared to group 1. 13(27.1%) patients achieved postoperative emmetropia in straight incision group while 24 (50%) patients achieved post operative emmetropia in frown incision group. All
patients achieved a BCVA of ≥ 6/18. The mean magnitude of preoperative astigmatism in straight incision was 1.26± 0.92 D and in frown incision was 0.98 ± 0.83 D. The mean magnitude of postoperative astigmatism in straight incision was 1.52±1.17 D and in frown incision was 0.99 ± 0.82D and was found to be statistically significant, p=
0.012. The centroid of SIA for straight incision was 1.4x1° with a coherence of 90% and the centroid of SIA for frown incision was 0.62x2° with a coherence of 70%. Conclusion: The visual outcome of frown incision group was slightly better than the visual outcome in straight incision group. All patients achieved a BCVA ≥ 6/18. The difference in
visual acuity was not found to be statistically different. The SIA of straight incision was significantly more than that of frown incision. (p <0.001).

Keywords: SIA; SICS; Postoperative astigmatism; Straight incision; Frown incision; MSICS.