Purpose: To evaluate safety and efficacy of intracameral Phenocaine plus as a supplement to conventional topical proparacaine anesthetic drops in cataract surgery.

Methods: A prospective and controlled study including 100 patients suffering with bilateral cataract were assigned to 2 different groups for the type of anesthesia received, 0.5% proparacaine hydrochloride  drops in the first eye, and 0.5% proparacaine drops augmented with intracameral Phenocaine plus in the fellow eye for phacoemulsification surgery . At the end of surgery questionnaire were assigned to patient in both groups indicating the degree of pain (0-3) felt during the surgery.

Results: Thirty-six percent of patients in group 1 declared to have not felt any pain against the 84% of patients in group 2. Fifty-six percent of patients in group 1 complained about only a slight discomfort against 16% of group 2 patients. Only a small percentage of patients in group 1 (8%) admitted severe pain, while no patient in group 2 admitted severe pain. Postoperative day 1 unaided visual acuity was in the range of 6/18–6/9 for most of the patients. No adverse event like corneal decompensation or TASS were noted. Two patients in group 2 reported an episode of transient IOP spike, lasting several hours after surgery and 1 patient in group 2 had corneal edema resolving at end of 1 week after surgery

Conclusion: Intracameral administration of Phenocaine plus is a safe, simple and readily available method to increase the analgesia and in addition mydriasis during the cataract surgery, eliminating the discomfort and increasing the cooperation of the patients during surgery.