Objective: To investigate the effect of phacoemulsification with coaxial conventional incision and micro incision on corneal astigmatism, vision and tear inflammatory factors in cataract patients. Methods: 80 cataract patients who were treated in our hospital from January 2018 to December 2019 were selected, they were randomly divided into two groups: control group (n = 40) and study group (n = 40). Patients in the control group were treated with coaxial conventional incision phacoemulsification, while patients in the study group were treated with coaxial micro incision phacoemulsification. Intraoperative anterior chamber stability, best corrected vision, average ultrasound energy, corneal astigmatism, effective phacoemulsification time, lacrimal inflammatory factors and postoperative recovery time in the two groups were compared, the incidence of postoperative complications was recorded. Results: The best corrected visual acuity of the two groups increased 1d after operation, 1 week after operation, 1 month after operation, 3 months after operation, and the study group was higher than the control group (P 0.05). The recovery time of the study group was shorter than that of the control group (P 0.05). Conclusion: Compared with the coaxial conventional incision phacoemulsification, the coaxial micro incision phacoemulsification can improve the corneal astigmatism, visual acuity and the level of tear inflammatory factors, without increasing the incidence of postoperative complications.