AIM:To evaluate the reliability and effectiveness of topical anesthesia,topical combined with subconjunctival anesthesia and retrobulbar anesthesia in phacoemulsifi-cation and intraocular lens implantation combined with trabeculectomy.METHODS:Ninety patients(120 eyes) according to admission time were divided into three groups,and underwent the combined surgery of phacoemulsification and intraocular lens implantation combined with trabeculectomy by using topical anesthesia,topical combined with subconjunctival anesthesia and retrobulbar anesthesia respectively.The anesthetic effect and complications intaroperation and postoperation were observed.RESULTS:In topical anesthesia group,3 eyes were given additional subconjuncival anesthesia due to lack of intraoperative anesthesia and 11 cases were not successfully completed due to unsuccessfully satisfactory analgesic effect.All the 30 eyes were successfully completed with satisfactory analgesic effect and without any intraoperative and postoperative potential risk in topical combined with subconjunctival anesthesia group.And in retrobulbar anesthesia group,one eye had transient amaurosis,3 eyes were retrobulbar hemorrhage after operation and one eye’s eyelid was bruising after surgery,with the affective methods of intaroperation and postoperation,these operations all successfully completed.CONCLUSION:Topical combined with subconjunctival anesthesia is the most safe and effective way in these three anesthesia methods,which has an advantage over topical or retrobulbar anesthesia.