AIM: To explore that double steep axial transparent corneal incision can effectively minimize corneal astigmatism and high-order aberration(HOA)in cataract patients with moderate to low degree corneal astigmatism, as well as improve postoperative visual quality.

METHODS: A total of 60 cataract patients diagnosed with moderate to low corneal astigmatism in our hospital from October 2020 to July 2021 were randomly divided into group A(normal 135° incision, 30 cases)and group B(double steep axial transparent corneal incision, 30 cases). The uncorrected visual acuity(UCVA), astigmatism, astigmatism vector decomposition, polar keratometry(Polar K), second-order astigmatism, spherical, coma and trefoil aberration within 3mm of the central pupil were compared at 1 and 3mo before and after surgery.

RESULTS: UCVA of group A and group B at 1 and 3mo after surgery was significantly higher than that before surgery(P<0.05). The mean UCVA of group B was higher than that of group A at 1 and 3mo after surgery, but the difference was not statistically significant(P>0.05). The corneal astigmatism of group A at 1 and 3mo postoperative were not significantly different from that before surgery(P>0.05).The mean corneal astigmatism of group B was 0.66±0.13 and 0.61±0.12D at 1 and 3mo after surgery, respectively, which was significantly lower than the preoperative value of 1.38±0.24D(P<0.05). In group B, there was no significant change in CJ0/CJ45 at 1 and 3mo after surgery(P>0.05). In group A, CJ0/CJ45 were both significantly different from those at 1 and 3mo before surgery(P<0.05).The polar astigmatism values of group B at 1 and 3mo after surgery were lower than those before surgery(P<0.05), while they were increased in the group A at 1 and 3mo after surgery(P<0.05). HOA of both group A and B at 3mo after surgery was lower than that before surgery(P<0.05). The mean HOA of group B was lower than that of group A at 3mo after surgery, but the difference was not statistically significant(P>0.05). The coma aberration of group B at 3mo after surgery was lower than that before surgery and group A.

CONCLUSION: For cataract patients with moderate to low corneal astigmatism, there was no significant difference in postoperative UCVA and HOA between double steep axial transparent corneal incision and normal incision. However, compared with normal incision, double steep axial transparent corneal incision can improve postoperative visual quality by effectively reducing corneal astigmatism and coma aberration.