Purpose: To compare Toric IOLs and Peripheral corneal relaxing incisions for correcting pre-operative astigmatism in eyes undergoing cataract surgery. Setting: M. D. Eye Hospital, Regional Institute of Ophthalmology, Prayagraj, India. Design: Prospective Observation study. Method: Eyes with astigmatism of ≥1.5 D undergoing cataract surgery either with the rule astigmatism (WTR) or against the rule astigmatism (ATR) confirmed by corneal topography between November 2018 to October 2019 were included in the study. The same surgeon performed phacoemulsification/SICS with PCRI to reduce pre-existing astigmatism. Result: In our study 35 eyes of 35 patients were included. 10 eyes of 10 patients underwent Toric IOL implant who had >2.00 D of astigmatism & 25 eyes of 25 patients had mild astigmatism and underwent SICS with PCRI. Patients were followed up regularly till 10 weeks. In Toric IOL implant group 90% patients of moderate to higher order astigmatism had BCVA in the range of 6/9–6/6. Eyes underwent SICS with PCRI 60% of the patients had BCVA 6/9-6/6. Only few patients required cylindrical glasses post-operatively. Conclusion: PCRI cannot be used for moderate to high astigmatism. Spectacle dependence of PCRI group was more than Toric IOL group. Although cost wise PCRI is better option over Toric IOL implant for correcting pre-operative astigmatism.

Keywords: With the Rule (WTR) astigmatism; Against the rule (ATR) astigmatism; Peripheral corneal relaxing incision (PCRI).