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Clinical and electrophysiologic results after intracameral lidocaine 1% anesthesia: a prospective randomized study
N Anders1, T Heuermann, K Rüther
1Department of Ophthalmology, Charté, Faculty of Humboldt University, Berlin, Germany. norbert.anders@charite.de
Objective:
To evaluate the efficacy and safety of intracameral lidocaine in cataract surgery compared to peribulbar anesthesia.
Design:
A prospective, randomized, controlled study.
Participants:
A total of 200 consecutive cataract patients (200 eyes) participated.
Intervention:
Eyes were randomly assigned to two groups: one group received 0.15 ml intracameral 1% unpreserved lidocaine combined with topical anesthesia (oxybuprocaine); the other group received 6 ml prilocaine peribulbar before phacoemulsification with sclerocorneal tunnel incision.
Main Outcome Measures:
Duration of surgery was measured; implicit time and amplitudes of the b-waves of the photopic electroretinogram (ERG) potentials (single-flash ERG and the 30-Hz flicker ERG) were recorded; frequencies of intraoperative problems, complications, intraoperative, and postoperative pain were evaluated.
Results:
After lidocaine anesthesia combined with topical anesthesia, similar complications were found, longer operation time (P < 0.001), and significantly better visual acuity immediately after surgery (P < 0.001). The ERG amplitudes were not significantly reduced after 0.15-ml intracameral lidocaine half an hour after surgery (P > 0.05).
Conclusion:
Intracameral lidocaine 1% combined with topical anesthesia can be recommended as an alternative procedure to peribulbar anesthesia in cataract surgery with corneoscleral tunnel incision.