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Efficacy of supplementary intracameral lidocaine in routine phacoemulsification under topical anesthesia
T Gillow1, S M Scotcher, J Deutsch
1Victoria Eye Hospital, Hereford, England. steve@scotcher.freeserve.co.uk
Objective:
To determine whether the routine use of supplementary intracameral lidocaine has any benefit over topical anesthesia alone when performing phacoemulsification surgery.
Design:
A prospective single-center, randomized, double-masked, clinical trial.
Participants:
A total of 204 patients undergoing phacoemulsification surgery with lens implantation under planned topical anesthesia.
Methods:
Patients were randomly allocated to receive either topical anesthesia plus 0.5 ml intracameral balanced salt solution or topical anesthesia plus 0.5 ml preservative-free 1% intracameral lidocaine.
Main Outcome Measures:
On the day after surgery, patients were asked to document the discomfort they had experienced using a visual analog scale. Intraoperative discomfort, postoperative discomfort, and discomfort caused by the microscope light were assessed.
Results:
Multiple linear regression analysis did not show any significant relationship between the use of intracameral lidocaine and either intraoperative (P = 0.34) or postoperative (P = 0.45) pain scores. There was a small reduction in the discomfort caused by the operating microscope when intracameral lidocaine was used (P = 0.04).
Conclusions:
In this study, the routine use of intracameral lidocaine as a supplement to topical anesthesia was shown not to have a clinically useful role.