Background: Phacoemulsification with intraocular lens implantation for cataracts is amongst the most prevalent ophthalmology procedures for cataract patients to improve eyesight. This study is aimed to investigate the alteration in microvascular blood flow and macular retinal thickness by OCTA in cataract individuals following phacoemulsification. Methods: This study included 50 Egyptian patients with cataract that were selected from the department of ophthalmology at Benha University hospital and Benha Health Insurance hospitals. The main aim was to evaluate macular vasculature changes pre and post phacoemulsification. Two groups of participants were formed: Low energy power group: 25 patients were enrolled with low energy used in phacoemulsification surgery group, and a high energy power group: 25 patients were enrolled with high energy used in the phacoemulsification surgery group. Results: The nuclear hardness showed a significant difference between both groups. Eyes number with grade 3 nuclear toughness was substantially lower in low-energy than high-energy group, since eyes number with grade 2 nuclear hardness was substantially higher in low-energy than high-energy group (P value= 0.001). 1 week post surgery, low-energy group postoperative BCVA was greater compared to high-energy group. (0.86 ± 0.17 vs 0.70 ± 0.18, P value=0.002) and at 1m (0.84± 0.19 vs 0.74 ± 0.18, P value=0.044) post-operation. Conclusion: After cataract surgery, phacoemulsification provides a reasonable effective result, with improved macular thickness, decreased foveal avascular zone (FAZ) area, and insignificant modifications in microvascular density in the peripapillary region.