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AIM: To compare the efficiency of coaxial micro-incision cataract surgery(MICS)performed by 3 phacoemulsification techniques(phaco-chop, divide-and- conquer and stop-and-chop).<p>METHODS: It was a perspective and randomized clinical trial. Totally 135 patients with age-related cataract were selected randomly and underwent MICS. According to the lens nuclear opacity(NO)of LOCSⅢ grading standards, it can be divided into 3 groups as NO2, NO3 and NO4 group. All groups were randomly subdivided into 3 groups(phaco-chop, divide-and-conquer and stop-and-chop group). The observation target included best-corrected visual acuity(BCVA), central corneal thickness(CCT)and endothelial cell count(ECC)before operation and 1mo postoperation, ultrasound time(UST), cumulative dissipated energy(CDE), estimated fluied used(EFU)in operation and complications.<p>RESULTS:In lens nuclear opacity NO4 coaxial micro-incision phacoemulsification, phaco-chop group showed significantly less UST, CDE and EFU than the divide-and-conquer and stop-and-chop groups(<i>P<</i>0.05)and the ratio of endothelial cell loss was significantly lower in the phaco-chop group than in the divide-and-conquer and stop-and-chop groups 1mo after surgery(<i>P<</i>0.05). However, after 1mo surgery, BCVA and CCT among three chop technique groups in different lens nuclear opacity groups had no significant differences(<i>P></i>0.05).<p>CONCLUSION: All 3 techniques may be effective for coaxialmicroincision cataract surgery in mild and moderate nuclear opacity cataracts. However, in eyes with severe nuclear opacity cataract, the phaco-chop technique can be more effective for phacoemulsification, and less corneal endothelial damage.