Small incision self-sealing cataract surgery has created the opportunity to use less invasive anesthesia. One hundred patients were evaluated in a prospective study using a new technique of topical anesthesia to allow small incision construction, intercapsular phacoemulsification, and small incision intraocular lens implantation without a peribulbar or retrobulbar injection. This study demonstrated that topical anesthesia avoids the risk of globe perforation, retrobulbar hemorrhage, and prolonged postoperative akinesia of the eye and is effective for intraoperative anesthesia for cataract surgery.