Abstract: Preoperative astigmatism is a key determinant of postoperative visual quality in cataract surgery. Accurate ocular biometry and individualized surgical planning are essential for effective astigmatism correction. For patients with conditions such as dry eye, tear film stabilization prior to measurement is necessary to ensure reliable data acquisition. Currently, four main approaches are commonly employed to correct astigmatism during cataract surgery: (1) Clear corneal incision at the steep meridian, suitable for astigmatism <1.00 D; (2) Peripheral corneal relaxing incision, which provides 1.00-3.00 D of correction and serves as a practical alternative when toric intraocular lens (IOL) is unavailable; (3) Toric IOL implantation, regarded as the most effective method, capable of correcting 0.75-4.00 D of astigmatism; and (4) Femtosecond laser-assisted arcuate keratotomy, offering precise and controllable correction of corneal astigmatism.These techniques may be applied individually or in combination to achieve optimal refractive outcomes.

Key words: Cataract surgery, Astigmatism, Clear corneal incision, Peripheral corneal relaxing incision, Toric intraocular lens, Femtosecond laser-assisted cataract surgery