We used computerized videokeratography to analyze corneal topographical changes in 39 eyes of 39 patients who had phacoemulsification and posterior chamber lens implantation through 4 mm incisions. In one group of patients, the incisions were closed with a single vertical mattress suture; in the other group, no sutures were used. Computerized videokeratography was performed preoperatively and at one and five to six weeks postoperatively; corneal curvatures were assessed at radial distances of 0.75, 1.5, 2.5, and 3.5 mm along the 0-, 90-, 180-, and 270-degree semimeridians. At one week postoperatively, there was slightly more steepening along the 90- and 270-degree semimeridians (up to 0.9 diopters [D]) and slightly more flattening along the 0- and 180-degree semimeridians (up to 0.6 D) in the sutured group. At six weeks postoperatively, all mean semimeridional changes were less than 0.5 D. Computerized videokeratography demonstrated that sutured and unsutured 4 mm incisions induced clinically small corneal topographic changes and detected local variations in corneal curvature that may be due to sutures, cautery, and other operative factors.