Viscous tetracaine hydrochloride 0.5% for topical anesthesia in cataract surgery

For the past decade, lidocaine 2% gel has been one of the more commonly used agents for topical anesthesia in cataract surgery, particularly in the USA. Given its prolonged contact time with the ocular surface by nature of its viscosity, it has been found to provide superior anesthesia relative to anesthetic drops. A downside to this inexpensive and efficacious agent is that it was never intended to be used for ophthalmic surgery and, as a result, is packaged in a tube rendering it somewhat messy to apply. TetraVisc(TM) is a high-viscosity formulation of tetracaine hydrochloride 0.5% that is packaged in a sterile ophthalmic dropper bottle. A single report in the literature suggests that it is of equal efficacy to lidocaine 2% gel as a topical anesthetic for routine cataract surgery.