AIM: To investigate the effects of small incision extracapsular excision and phacoemulsification on the number of corneal endothelial cells, macular thickness and surgically induced corneal astigmatism in cataract patients.

METHODS: Retrospective research. A total of 296 age-related cataract patients(296 eyes)admitted to our hospital from May 2019 to February 2023 were selected. They were divided into a small incision extracapsular excision group(144 eyes)and a phacoemulsification group(152 eyes)according to surgical method. The uncorrected visual acuity, best corrected visual acuity, numbers of corneal endothelial cells, macular thickness, surgically induced corneal astigmatism and postoperative complications between the two groups of patients at 7d, 1 and 3mo after surgery were compared.

RESULTS: The uncorrected visual acuity and best corrected visual acuity of patients in the small incision extracapsular excision group after 7d of surgery were better than those of the phacoemulsification group, the number of corneal endothelial cells after 7d and 1, 3mo of surgery were higher than that of the phacoemulsification group, the macular thickness after 7d and 1mo of surgery was lower than that of the phacoemulsification group, and the incidence rate of postoperative corneal edema and incidence rate of total complications were lower than those of the phacoemulsification group(all P<0.05). Furthermore, there was no statistical significance in the values of surgically induced corneal astigmatism after 1, 7d and 1, 3mo of surgery compared with phacoemulsification group(P>0.05).

CONCLUSION: Compared with phacoemulsification, the changes in the number of corneal endothelial cells and thickness of the macular area after small incision extracapsular excision are relatively small, visual recovery is faster, and the complications reduced.