Twenty patients who had phacoemulsification using a small, self-sealing incision were evaluated one year after surgery for astigmatic changes. Keratometric analysis was performed using the EyeSys photokeratoscope, and data for the 3 mm corneal zone for each patient were recorded. Results were compared with those reported for the one-week and one-month postoperative periods. From one month to one year, a minimal amount of additional against-the-rule change in cylinder occurred. Because the range of changes was broad, it was difficult to predict the direction of astigmatic change (i.e., against the rule versus with the rule) that would occur over time for a given patient.