The basis of manual small incision cataract surgery is the tunnel construction for entry to the anterior chamber. The parameters important for the structural integrity of the tunnel are the self-sealing property of the tunnel, the location of the wound on the sclera with respect to the limbus, and the shape of the wound. Cataract surgery has gone beyond just being a means to get the lens out of the eye. Postoperative astigmatism plays an important role in the evaluation of final outcome of surgery. Astigmatic consideration, hence, forms an integral part of incisional considerations prior to surgery.

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