Objective To investigate the effect of cataract phacoemulsification (Phaco) combined with goniosynechialysis on patients with glaucoma combined with cataract, and to provide clinical reference. Methods A total of 200 patients with glaucoma combined with cataract admitted to Unit 32397 of the People’s Liberation Army from January 2021 to June 2022 were selected as the study object. According to the random number table method, they were divided into goniosynechialysis group and trabecular resection group, with 100 cases each group. Patients in the goniosynechialysis group were treated with Phaco combined with goniosynechialysis, and patients in the trabecular resection group were treated with Phaco combined with trabecular resection. Visual acuity, intraocular pressure, astigmatism, hamilton anxiety scale (HAMA), hamilton depression scale (HAMD) scores, and complications were compared between the two groups. Results There was no significant difference in visual acuity between the two groups (P>0.05). After surgery, the intraocular pressure in both groups was lower than preoperative, and the astigmatism was higher than preoperative, and the astigmatism in the goniosynechialysis group was lower than the trabecular resection group (P<0.05).There was no significant difference in intraocular pressure between the two groups (P>0.05). After surgery, HAMA and HAMD scores in two groups were lower than preoperative, and the goniosynechialysis group was lower than that of the trabecular resection group (P<0.05). The complication rates of patients in the goniosynechialysis group were lower than those improvemed in the trabecular resection group (P<0.05). Conclusion Phaco combined with goniosynechialysis has certain effects on vision and intraocular pressure improvement in patients with glaucoma combined with cataract, especially in terms of reducing astigmatism, risk of complications and HAMA and HAMD scores, which is worthy of clinical application.