Objective To investigate the hemodynamic changes and therapeutic effects of phacoemulsification and cataract extraction before and after treatment in patients with senile angle-closure glaucoma (ACG). Methods A total of 86 patients with senile ACG were randomly divided into control group ( n = 43) and experiment group (n= 43), and treated with trabeculectomy and phacoemulsification, respectively. For patients in both groups, the intraocular pressure ( IOP) and hemorheology, and their correlation with visual acuity, incidence of complica- tions, anterior chamber depth, and angle adhesion closure were observed and analyzed. Results Before treatment, there were no significant differences in visual acuity and IOP, plasma viscosity, hematocrit and platelet adhesion rate, anterior chamber depth and angle adhesion closure for patients in both groups (P>0. 05). After treatment, compared with the control group, the experiment group showed higher visual acuity (P<0. 05) and lower IOP ( P < 0. 05), lower incidence of complications ( P < 0. 05), as well as lower plasma viscosity,1039 hematocrit and platelet adhesion rate (P<0. 05). The anterior chamber depth and angle adhesion closure of the experiment group were significantly improved (P<0. 05), and the therapeutic effect was significantly higher (P< 0. 05). Conclusions Phacoemulsification and cataract extraction can effectively enhance the therapeutic effect for patients with senile ACG, further reduce the incidence of complications, promote the improvement of IOP and visual acuity, significantly improve anterior chamber depth and hemodynamic stability, effectively control angle adhesion closure, which can be promoted in the treatment for patients with senile ACG.