AIM:To compare the efficacy and visual results of the modified Blumenthal and Ruit techniques for manual small-incision cataract surgery(MSICS).· METHODS:This was a prospective,non-randomized comparison of 129 patients with senile cataracts scheduled to undergo routine cataract surgery via either a superior scleral tunnel incision,i.e.,the Blumenthal technique(group 1,n = 64) or a temporal scleral tunnel incision,i.e.,the Ruit technique(group 2,n =65).MSICS and intraocular lens implantation were performed through an unsutured 6.5-to 7.0-mm scleral tunnel incision.Uncorrected and corrected visual acuity,intraoperative and postoperative complications,and surgically induced astigmatism calculated by simple subtraction were compared.Patients were examined at 1 day,1 week,1 month,and 3 months after surgery.· RESULTS:Both groups achieved good visual outcome with minor complications.Three months after surgery,the corrected visual acuity was 0.73 in the Blumenthal group and 0.69 in the Ruit group(P =0.29).The average(SD) postoperative astigmatism was 0.87(0.62) diopter(D) for the Blumenthal group and 0.86(0.62) D for the Ruit group.The mean(SD) surgically induced astigmatism was 0.55(0.45) D and 0.50(0.44) D for the Blumenthal and Ruit groups,respectively(P =0.52).Common complications were minimal hyphema and corneal edema.There was no statistically significant difference in the complication rate between the groups(P >0.05).· CONCLUSION:In MSICS,both the Blumenthal and Ruit techniques achieved good visual outcomes,with low complication rates. AIM: To compare the efficacy and visual results of the modified Blumenthal and Ruit techniques for manual small-incision cataract surgery (MSICS). METHODS: This was a prospective, non-randomized comparison of 129 patients with senile cataracts scheduled to undergo routine cataract surgery via either a superior scleral tunnel incision, ie, the Blumenthal technique (group 1, n = 64) or a temporal scleral tunnel incision, ie, the Ruit technique (group 2, n = 65) through an unsutured 6.5-to 7.0-mm scleral tunnel incision. Uncorrected and corrected visual acuity, intraoperative and postoperative complications, and surgically induced astigmatism calculated by simple subtraction were compared. Patients were examined at 1 day, 1 week, 1 month, and 3 months after surgery. · RESULTS: Both groups achieved good visual outcome with minor complications. Three months after surgery, the corrected visual acuity was 0.73 in the Blumenthal group and 0.69 in the Ruit (SD) postoperative astigmatism was 0.87 (0.62) diopter (D) for the Blumenthal group and 0.86 (0.62) D for the Ruit group. The mean (SD) surgically induced astigmatism was 0.55 (0.45 ) D and 0.50 (0.44) D for the Blumenthal and Ruit groups, respectively (P = 0.52) .Common complications were minimal hyphema and corneal edema.There was no statistically significant difference in the complication rate between the groups (P> 0.05). CONCLUSION: In MSICS, both the Blumenthal and Ruit techniques achieved good visual outcomes, with low complication rates.