Abstract: Objective To explore the influence of phacoemulsification with 2.2 mm and 3.0 mm corneal incisions on postoperative corneal refractive power and astigmatism. Methods A total of 120 patients(120 eyes)who underwent cataract phacoemulsification combined with intraocular lens implantation in our hospital were selected, and were divided into observation group and control group according to the random number table method, with 60 cases(60 eyes)in each group. Patients in the observation group received 2.2 mm corneal incision phacoemulsification and those in the control group received 3.0 mm corneal incision. The uncorrected visual acuity and the best positive visual acuity before operation and 1 week, 1 month and 3 months after the operation were checked up, and the Jaffe/Clayman analysis method was used to observe the changes of vector change(SIA)value and total SIA value of astigmatism on the anterior and posterior corneal surface of the two groups at different time points. Results The uncorrected visual acuity at 1 day and 1 week after operation and the best corrected visual acuity at 1 day, 1 week and 1 month after operation in the observation group were higher than those in the control group, the differences were statistically significant(P<0.05); compared with the control group, there were no statistically significant differences in the uncorrected visual acuity before operation, 1 month and 3 months after operation, and the best corrected visual acuity before operation and 3 months after operation between the observation group and control group(P>0.05). The- SIA values of the anterior corneal surface and posterior corneal surface of the observation group were lower than those of the control group at 1 day, 1 week, 1 month and 3 months after surgery, but there were no significant differences between the groups(P>0.05). The corneal total SIA value and posterior surface SIA value at 1 week, 1 month, and 3 months in the two groups showed significant differences when compared with those of first postoperative day(P<0.05). SIA values of the anterior corneal surface at 1 month and 1 day after surgery showed significant differences in the observation group compared with its value in the first postoperative day(P<0.05), and SIA value of the anterior corneal surface at only 3 months after surgery in the control group showed significant significance compared with its value at 1 day after surgery(P<0.05). Conclusion Phacoemulsification with 2.2 mm corneal incision combined with implantation of artificial lens is more stable in corneal incision conditions than 3.0 mm corneal incision, and has better refractive stability in the early postoperative period. In the long run, refractive power and astigmatism between the two surgical incisions have less difference.