Abstract: The core issue of corneal edema after phacoemulsification lies in the dysfunction of the "pump-barrier" mechanism caused by damage to corneal endothelial cells. Its occurrence is influenced by multiple risk factors, including patient-specific conditions, intraoperative procedures, and postoperative management. Therefore, prevention and treatment must be systematic: the primary focus is on prevention, emphasizing meticulous preoperative assessment and optimized surgical techniques to minimize endothelial damage. Once edema occurs, a personalized, stepwise approach is required. Mild to moderate edema is primarily managed with medications to promote absorption, while severe edema unresponsive to medication, Descemet's membrane detachment, or corneal decompensation necessitate surgical intervention. In summary, successful management relies on the comprehensive identification of risk factors, meticulous perioperative care, and targeted treatment. The fundamental breakthrough for the future lies in promoting effective regeneration and repair of endothelial cells.