·AIM:To compare the efficacy and visual results of the modified Blumenthal and Ruit techniques for manual small-incision cataract surgery(MSICS).·METHODS:This was a prospective,non-randomized comparison of 129 patients with senile cataracts scheduled to undergo routine cataract surgery via either a superior scleral tunnel incision,i.e.,the Blumenthal technique(group 1,n=64)or a temporal scleral tunnel incision,i.e.,the Ruit technique(group 2,n=65).MSICS and intraocular lens implantation were performed through an unsutured 6.5-to 7.0-mm scleral tunnel incision.Uncorrected and corrected visual acuity,intraoperative and postoperative complications,and surgically induced astigmatism calculated by simple subtraction were compared.Patients were examined 1 day,1 week,1 month,and 3 months after surgery.·RESULTS:Both groups achieved good visual outcomes with minor complications.Three months after surgery,the corrected visual acuity was 0.73 in the Blumenthal group and 0.69 in the Ruit group(P=0.29).The average(SD)postoperative astigmatism was 0.87(0.62)diopter(D)for the Blumenthal group and 0.86(0.62)D for the Ruit group.The mean(SD)surgically induced astigmatism was 0.55(0.45)D and 0.50(0.44)D for the Blumenthal and Ruit groups,respectively(P=0.52).Common complications were minimal hyphema and corneal edema.There was no statistically significant difference in the complication rate between the groups(P>0.05).·CONCLUSION:In MSICS,both the Blumenthal and Ruit techniques achieve good visual outcomes,with low complication rates.·