Efficacy of Chevron versus Frown Incisions and Surgically Induced Astigmatism in Small Incision Cataract Surgery: A Research Protocol

Introduction: Cataracts are a leading cause of treatable blindness worldwide, significantly affecting vision, particularly in the elderly. While various surgical techniques exist, Manual Small Incision Cataract Surgery (MSICS) remains a common option, especially in resource-limited settings. Need for the Study: The magnitude of Surgically Induced Astigmatism (SIA) is primarily influenced by the corneal incision. Incision size, shape, and axis can be modified to minimise SIA and optimise postoperative outcomes. A key challenge in cataract surgery is managing SIA, which can hinder optimal visual results. The present study will evaluate different incision types used in MSICS, including chevron, frown, and straight incisions, examining their impact on SIA and wound integrity. The discussion highlights the evolution of incision techniques aimed at minimising astigmatism and achieving better visual acuity for cataract patients. Aim: To evaluate the efficacy of chevron versus frown incisions in preventing SIA in small-incision cataract surgery. Materials and Methods: A two-arm parallel randomised controlled trial will be conducted in the Department of Ophthalmology, Acharya Vinoba Bhave Rural Hospital, Sawangi, Maharashtra, India, from June 2024 to June 2026. A total of 116 patients will be included and allocated into two groups (Group C and Group F), 58 in each. Keratometry readings, Uncorrected Visual Acuity (UCVA), and slit-lamp examination will be performed at each follow-up visit to assess postoperative outcomes. The statistical analyses will compare the magnitude of SIA between the Chevron and Frown incision groups using an independent t-test, and changes in the axis of astigmatism will be analysed using the Chi-square test. A p-value <0.05 will be considered statistically significant.