Background:Topical anesthetic is frequently utilized in vitrectomy, cataract, glaucoma, and combination cataract and glaucoma procedures. The present study was conducted to compare proparacaine hydrochloride topical drop and intracameral 0.5% lignocaine for phacotrabeculectomy in patients with primary open angle glaucoma. Materials & Methods:88 patients with primary open angle glaucoma scheduled for Phacotrabeculectomy of both genderswere divided into 2 groups of 44 each. Group I patients received proparacaine 0.5% eye drops and group II patients received 1% intracameral lignocaine just prior to phacotrabeculectomy and 0.5% intracameral lignocaine after completion of phacoemulsification just prior to trabeculectomy. The visual analogue scale, and surgeon discomfort were noted. Results:Group I had 24 males and 20 females and group II had 21 males and 23 females. In group Iand group II, posterior capsular rent was seen in 1 and 1, recurrent iris prolapsein 2 and 1, zonular dehiscence in 1 and 2, inadvertent eye movement in 12 and 10, eye lid squeezing in 7 and 6 and supplemental anesthesia in 16 and 14 patients. The difference was significant (P< 0.05). Grade 0 was seen in 24 in group I and 25 in group II, grade 1 in 10 and 11, grade 2 in 6 and 5 and grade 3 in 4 and 3 patients respectively. The difference was significant (P< 0.05). Conclusion: After phacoemulsifying the nucleus, a skilled surgeon can conduct phacotrabeculectomy using topical proparacaine supplemented with 0.5% intracameral lignocaine. Both anesthetic approaches provide a safe and comfortable surgical environment while avoiding injection-related risks of retrobulbar or peribulbar anesthesia.