BACKGROUND: It is important to control the intraocular pressure (IOP) during ophthalmic surgery. The emergence from the anesthesia is another challenging period to control the IOP. METHODS: The authors have compared IOP, blood pressure (BP) and heart rate (HR) with the removal of laryngeal mask airway (LMA-R) or tracheal extubation (ET) during the emergence from the propofol anesthesia. All data were recorded in the operating room upon arrival (Phase 1), just before the LMA-R or ET (Phase 2), immediately after (Phase 3), and 3 minutes (Phase 4) after the LMA-R or ET. RESULTS: The IOP with the LMA-R was significantly lower at Phase 2 and Phase 3 than that with the ET. The changes of the IOP between Phases 1 and 2, and 3 and 4 was insignificant in LMA-R but significant in ET. The differences in BP and HR were not significant between LMA-R and ET. CONCLUSIONS: The LMA-R offers advantages over ET for ophthalmic surgery in respect to the changes in IOP during the emergence of propofol anesthesia.