Background:  Despite the advance of cataract surgery astigmatism still occur after cataract surgery due to several reasons these include the preparation and closure of the surgical wound, the choice of suture material, and both intraoperative and postoperative manipulations in Phacoemulsification and Extracapsular cataract Etraction. Objectives: To evaluate cataract surgery as cause of astigmatisms among patients undergoing phacoemulsification and extracapsular cataract extraction at eye department in KCMC hospital from Sept 2022 to April 2023 Methods: It is a clinic-based, prospective cohort study. Keratometric values and demographic data were collected for eligible patients who had undergone phacoemulsification and Extracapsular Cataract Extraction using a non-contact Auto Refkeratometer BARK-80. Results: A total of 215 patients were recruited for the study. There were 129 (60%) females and 86 (40%) males. The mean age was 67.481 (SD 10.79years). A total 110 patients had undergone phacoemulsification and 105 had undergone Extracapsular Cataract Extraction (ECCE). 189 (87.91%), had a magnitude greater or equal (≥) to 0.5 post OP astigmatism. The mean corneal astigmatism among all patients undergone ECCE were 2.29D (SD 1.41 D) and all undergone PHACO were 0.95D (SD 0.79 D). The mean astigmatism among patients who had cataract surgery done by specialist were 1.19D (SD 0.09 D) and 2.41D (SD 0.16 D) were done by residents There was no astigmatism in 7 patients (3.26%), with-the-rule (WTR) in 68 patients (31.63%), against-the-rule (ATR) in 112 patients (52.09%) and oblique astigmatism (OA) in 28 patients (13.02%). The tendency of a gradual change from with the rule (WTR) to against the rule (ATR) astigmatism was noted as the age advanced. Conclusion: The present study reveals the magnitude of astigmatism is higher in patients underwent Extra Capsular Cataract Extraction than Phacoemulsification in eye department at KCMC hospital and pre-existing astigmatism is a cause of surgical induced astigmatism if pre-operative astigmatism correction is not taken into consideration.

The authors have declared no competing interest.

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This study was approved by the Kilimanjaro Christian Medical University College Research and Ethics Review Committee (KCMU CRERC) with clearance number PG 76/2022.

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