Objective: To examine the average change in keratometry’s medically produced astigmatism between lateral andphacoemulsification corneal incisions.Study Design: Randomized Controlled TrialStudy Duration and place of study: Department of Ophthalmology, Khyber Institute of Ophthalmic Sciences HMC,Peshawar. From 20-07- 2020 to 21-01-2021.Materials and Methods: A random allocation process divided 140 cataract patients into two groups. Phacoemulsification was performed using a superior corneal incision in group A and a temporal incision in group B. Baselineand follow-up keratometry readings were used to compute the average astigmatism change.Results: Patient age averaged 49.6 + 5.3 years throughout the research group. Group B patients averaged 50.4 +4.9 years old (p 0.04), whereas group A patients averaged 48.9 + 5.8 years. Group A included 82.9% males and17.1% women, whereas group B had 74.3% men and 25.7% women (p 0.217). Group A’s mean BMI was 24.9+ 3.8 kg/m2, whereas Group B’s was 25.2 + 3.7. A and B had mean baseline BCVAs of 0.8 + 0.2 and 0.8 +0.2, respectively (p 0.858). Keratometry showed group A’s mean baseline astigmatism was 0.2 + 0.06D and groupB’s 0.1 + 0.07 (p 0.614). Keratometry showed that group A’s mean follow-up astigmatism was 1.2 + 0.2D andgroup B’s 1.1 + 0.2 (p 0.836). According to keratometry, group A’s astigmatism changed by 1.0 + 0.17D andgroup B’s by 1.0 + 0.2 (p 0.707).Conclusion: We found no statistically significant difference in mean astigmatism before and after phacoemulsificationin corneal vs temporal incision groups. Our study had a limited sample size and did not account for effect modifiers, thuswe urge additional studies with higher sample sizes and accounting for confounders that may affect patients’ medicallyinduced astigmatism after phacoemulsification.Keywords: Senile Cataract, phacoemulsification, temporal incision superior corneal incision, astigmatism, keratometry.