Background Cataract surgery is one of the most frequent surgeries in the world. It is a very safe procedure mostly performed under topical anesthesia in outpatients centers. Due to the growing lack of anesthesiologists, cataract surgeries are more frequently performed without an anesthesiologist present in the operating room. Although extremely rare, life-threatening complications may occur. Cases presentation We report two cases of cataract surgery complicated by severe hypotension that required emergency resuscitation in the immediate postoperative period and hospitalization in intensive care unit. Anaphylactic shock was confirmed in the first case and suspected in the second. Conclusions and importance Even though cataract surgery is a very safe procedure, it is essential to ensure the presence of an anesthesiologist to manage potential, though extremely rare, life-threatening complications such as anaphylactic reactions.

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Cataract surgery is worldwide done under topical anesthesia in an outpatient basis with a complication rate less than 0,1%. We describe two cases of severe life-threatening hypotension needing anesthetic resuscitation. We recommand ophtalmogists to perform this very frequent surgery with an anesthetist on call to manage extremely rare life-threatening complications