Objective To investigate the clinical effect of cataract phacoemulsification combined with goniosynechialysis in the treatment of primary angle-closure glaucoma (PACG) patients combined with cataract and its effect on the open state of the angle of the patient's chamber and corneal endothelial cells. Methods The clinical data of 100 patients combined with PACG combined with cataract admitted to Yancheng NO.1 People's Hospital from January 2020 to May 2021 were retrospectively analyzed, they were divided into the group A (50 cases, receiving cataract phacoemulsification combined with trbecular ablation) and the group B (50 cases, receiving cataract phacoemulsification combined with goniosynechialysis) according to different surgical methods, all patients were followed up for 3 months. The minimum resolution angle logarithm (LogMAR), visual acuity, intraocular pressure, central anterior chamber depth and the open state of the angle before operation, 1 and 3 months after operation, corneal endothelial cell density (ECD), maximum cell area (MAX) and average cell area (AVE) before and 3 months after operation, and the incidence of complications during follow-up were compared between the two groups. Results Compared with before operation, the LogMAR value and intraocular pressure of the two groups decreased significantly at 1 and 3 months after operation, but the LogMAR value of the group B was significantly lower than that of the group A, and the intraocular pressure was significantly higher than that of the group A; the depth of central anterior chamber of the two groups was significantly higher, and the group B was significantly higher than that of the group A; the proportion of narrow atrial angle grade Ⅱ in the group A at 3 months after operation was significantly lower than that at 1 month after operation, the proportion of wide atrial angle in the group B at 3 months after operation was significantly higher than that at 1 month after operation; compared with the group A, the proportion of patients with wide atrial angle in the group B increased significantlyat 1 and 3 months after operation, and the proportion of patients with narrow atrial angle grade Ⅱ at 1 month after operation and patients with narrow atrial angle grade Ⅰ at 3 months after operation decreased significantly; 3 months after operation, the levels of MAX, AVE in the two groups and ECD in the group A significantly decreased, and the levels of MAX, AVE in the group B were significantly lower than those in the group A, and ECD was significantly higher than that in the group A; the total incidence of complications in the group B was significantly lower than that in the group A (all P<0.05). Conclusion Compared with cataract phacoemulsification combined with trabecular ablatrow, cataract phacoemulsification combined goniosynechialysis in the treatment of PACG patients combined with cataract can more effectively increase the open state of the patient's angle, improve visual function, reduce the loss of corneal endothelial cells, and have higher safety.