The purpose of this study was to compare the clinical results between 2.2 mm micro-coaxial cataract surgery (MCCS) and 2.8 mm small incision cataract surgery (SICS). Seventy-five patients (75 eyes) were divided into the MCCS (33 eyes) and SICS (42 eyes) groups. AcrySof IQ intraocular lenses were implanted into all patients. Effective phacoemulsification time, CDE (cumulative dissipated energy), and total amount of balanced salt solution (BSS) during cataract surgery were measured in the two groups. Visual acuity, spherical equivalent, intraocular pressure (IOP), endothelial cell count, corneal thickness, and surgically and 6 months. There were no statistically significant differences in effective phacoemulsification time, CDE, amount of BSS, visual acuity, spherical equivalent, IOP, endothelial cell count and corneal thickness, or SIA between the two groups. In conclusion, the clinical results of the 2.2 mm MCCS group and 2.8 mm SICS group revealed no significant differences.