Abstract: Corneal edema following phacoemulsification is a significant complication that adversely affects postoperative visual recovery and quality. Its core pathophysiological basis is the dysfunction of the "pump-barrier" mechanism resulting from damage to corneal endothelial cells. This article systematically reviews recent advances in risk factors, prevention, and management strategies. The occurrence of postoperative corneal edema is influenced by multiple factors related to the patient's own condition, intraoperative procedures, and postoperative course. Therefore, prevention is paramount, emphasizing meticulous preoperative assessment and optimization of surgical techniques. Once corneal edema occurs, treatment must adhere to the principle of individualization. For mild to moderate edema, pharmacological approaches can be employed to facilitate resolution. In cases of severe or persistent corneal edema that is unresponsive to medication, such as extensive Descemet's membrane detachment or corneal decompensation, surgical intervention becomes necessary. In conclusion, successful prevention and treatment rely on the comprehensive identification of risk factors, refined perioperative management, and targeted therapeutic measures. How to promote the regeneration and repair of endothelial cells represents a critical direction for future breakthrough research.