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AIM:To compare the effect of different incision in corneal astigmatism after phacoemulsification. <p>METHODS: Totally 88 cases(122 eyes)with pure cataract were randomly divided into two groups. Forty cases(60 eyes)were clarity corneal incision in group A, and 48 cases(62 eyes)were sclera tunnel incision in group B. Mean corneal astigmatism, surgically induced astigmatism(SIA), uncorrected visual acuity(UCVA)and best correct vision acuity(BCVA)were observed in pre- and post-operation at 1d; 1wk; 1mo.<p>RESULTS: The mean astigmatism had statistically significant difference between two groups at 1d; 1wk; 1mo after operation(<i>P</i><0.05). The SIA had statistically significant difference at 1d(<i>P</i><0.05); The SIA had no statistically significant difference between two groups at 1mo after operation(<i>P</i>>0.05). UCVA≥0.5 and BCVA≥0.8 had statistically significant difference at 1d; 1wk(<i>P</i><0.05). There had no statistically significant difference at 1mo after operation(<i>P</i>>0.05).<p>CONCLUSION: Phacoemulsification with scleral tunnel incision remove combined intraocular lens(IOL)implantation has small changes to corneal astigmatism. By selecting personalized corneal incision according to the corneal topography might be more beneficial.