Although SICS has a self sealing valved incision, there are certain cases where suturing is required, e.g. large or leading incision, pediatric cases and complications like premature entry. Suturing can be vertical or horizontal and either of them, can be interrupted, figure of eight or continuous. Horizontal sutures flatten the tunnel creating a physiological closure of the incision, thus decreasing the astigmatism. Vertical suture approximate the external incision but causes gaping in the internal incision. Hence, adversely affects the astigmatism.