PURPOSE. To study phacoemulsification in vitrectomized eyes under topical anesthesia, assessing anesthetic and intraoperative characteristics and complications. METHODS. A prospective study was performed on 52 eyes of 51 patients who underwent phacoemulsification of cataract with intraocular lens implantation under topical anesthesia, having previously undergone pars plana vitrectomy. Surgical and anesthetic observations and complications were recorded, as were visual outcomes. RESULTS. Ninety-two percent of patients had improved visual acuity postoperatively with only one patient having visual loss as a result of surgery. The most common intraoperative observations were of a deep anterior chamber, posterior capsular plaques, posterior synechiae, and nuclear sclerotic cataracts. Topical anesthesia proved satisfactory in 96%, with only two patients requiring intracameral lignocaine 1%; no patients required conversion to injection anesthesia. There were no major operative or postoperative complications. CONCLUSIONS. Phacoemulsification in vitrectomized eyes can be challenging, but is visually rewarding. Topical anesthesia proved satisfactory for the vast majority of cases, with none of our patients requiring conversion to injection anesthesia. © Wichtig Editore, 2007.