Objective To analyze the effects of phacoemulsification and intraocular lens implantation combined with goniosynechialysis on visual acuity and intraocular pressure of patients with angle closure glaucoma with cataract, provide reference for clinical treatment of the disease. Methods A total of 80 cases angle closure glaucoma with cataract patients who were admitted to Changshu No.1 People's Hospital from December 2018 to December 2021 were selected and divided into the control group (40 cases, treated with phacoemulsification and intraocular lens implantation combined with trabeculectomy) and the observation group (40 cases, treated with phacoemulsification and intraocular lens implantation combined with goniosynechialysis) by the random number table method, patients in the two groups were all followed up for 6 months. The clinical efficacy,the best corrected visual acuity (BCVA), intraocular pressure, central anterior chamber depth, central corneal thickness, mean corneal endothelial cell area, corneal endothelial cell density and quality of life scores before and one month after operation, and postoperative complications occurrence of patients in the two groups were compared. Results The total clinical effective rate of patients in the control group and observation group were 77.50% and 95.00%, respectively, and the observation group was significantly higher than the control group; compared with before operation, the logarithm of the minimum angle of resolution (logMAR) value and intraocular pressure of patients in the two groups decreased significantly one month after operation, and the observation group was significantly lower than the control group; central anterior chamber depth of patients in the two groups increased significantly, and the observation group was significantly higher than the control group; compared with before operation, the mean corneal endothelial cell area of patients in the two groups increased significantly one month after surgery, but the observation group was significantly lower than the control group; the density of corneal endothelial cells of patients in the two groups decreased significantly, but the observation group was higher than the control group (P<0.05), there was no significant difference in the corneal central thickness between the two groups (P>0.05); compared with before operation, the quality of life scores of patients in the two groups increased significantly one month after operation, and the scores of physical function, mental health, social function, emotional function and overall health of patients in the observation group were significantly higher than those in the control group; the postoperative complications occurrence rate of patients in the observation group was significantly lower than that in the control group (P<0.05). Conclusion Phacoemulsification and intraocular lens implantation combined with goniosynechialysis can improve the clinical effect of angle closure glaucoma with cataract patients, reduce intraocular pressure, improve visual acuity, alleviate the corneal endothelial function damage, reduce complications, and improve the quality of life.