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There were no statistically significant differences regarding pain intensity based on VAS scale and patient satisfaction based on ISAS between the two groups. Although, when the operation under topical anesthesia lasted nearly 30 minutes, hemodynamic changes occurred (increasing SBB, DBP and decreasing HR). Cataract surgery is the most common ophthalmic surgical procedure performed selleck inhibitor in the elderly. Regional anesthesia under monitored anesthesia care is often the preferred method for the elderly, because of their high age and underlying cardiopulmonary diseases (1-7). During the operation under MAC (Monitored Anesthesia Care), patients were fully monitored by an anesthesiologist and to reduce pain anxiety and patient comfort, they were given drugs during block (10, 14-17). There are numerous regional anesthetic methods for cataract surgery in different studies (6-9, 18, 19). Some studies demonstrated the preference this website of regional to topical anesthesia. In Ryu��s study, three methods of topical, retro bulbar and sub-Tenon were compared and it was found that mean arterial pressure and heart rate in the retro bulbar group were considerably higher than topical and sub-Tenon groups during and immediately after the block. On the other hand, in the sub-Tenon group, patient satisfaction was the maximum (1). In our study, there was no significant difference in patient satisfaction and pain intensity; only when topical surgery lasted for more than nearly 30 minutes, reduced satisfaction (P = 0.92), increased pain (P = 0.267) and hemodynamic changes (P Oxymatrine when surgery under topical anesthesia lasted more than 30 minutes, reduced satisfaction and pain intensity were resulted (no statistical significant). Balkan et al. conducted a study on 191 patients undergoing cataract surgery who received midazolam and fentanyl and found no significant difference in pain and need for sedative drugs, which was in line with the results of the present study (8). Jacobi et al. performed a study on 476 patients scheduled for cataract surgery using phaco emulsification techniques under retro bulbar anesthesia with bupivacaine 0.75%, lidocaine 2%, and hyaluronidase or topical anesthesia with lidocaine 2%. Surgical complications, intraoperative situation and pain intensity were evaluated based on VAS.