In cataract surgery, a satisfactory state of anesthesia is essential. The inadequately sedated patient may express his anxiety by restlessness, compulsive chattering, failure to cooperate, coughing, squeezing of the eyelids, and other reactions which increase the risk of operative complications. Surgical intervention on the eye, the most precious of the sense organs, arouses irrational but deep-seated fear. For this reason, most patients and many surgeons prefer general anesthesia.1 Aside from the desirability of having the patient conscious enough to respond to the surgeon's directions, there are many objections to general anesthesia. It is undesirable in a group which is largely elderly and arteriosclerotic; it involves the risk of heightened intraocular pressure and consequent vitreous loss,2 as well as the risk of cardiac arrest in the unconscious patient.3
We have therefore ruled out general anesthesia as a routine practice in cataract extraction. While we managed, in most cases,