To assess the anesthetic efficacy of tetracaine hydrochloride 0.5% (TetraVisc) versus lidocaine 2% jelly in routine cataract extraction.Private surgicenter, Warwick, Rhode Island, USA.A prospective randomized double-blind clinical trial comprised 100 patients having routine cataract extraction by clear corneal phacoemulsification. Patients were randomized to receive TetraVisc or lidocaine 2% jelly, applied once, approximately 5 minutes before surgery. Outcomes included a self-reported postoperative pain score and the need for supplemental anesthesia.The mean self-reported postoperative pain scores for TetraVisc and lidocaine 2% jelly were similar (0.94 and 1.02, respectively; P = .76). A single patient in the lidocaine group required supplemental anesthesia.TetraVisc was as effective as lidocaine 2% jelly as a topical anesthetic agent for routine cataract extraction.