Does preservative-free lignocaine 1% for hydrodissection reduce pain during phacoemulsification?

To compare preservative-free 1% lignocaine with balanced salt solution (BSS) in alleviating pain during hydrodissection in phacoemulsification cataract surgery.

West Norwich Hospital, Norfolk, United Kingdom.

This prospective double-masked trial comprised 68 patients having day-case phacoemulsification cataract surgery. Patients were randomly divided into 2 groups, receiving either BSS or lignocaine 1% solution for hydrodissection during routine uneventful phacoemulsification using topical anesthesia. The level of intraoperative pain was scored on a scale of 0 (no pain) to 10 (severe pain), and the scores between the 2 groups were compared.

Of the 68 patients, 33 (49%) received BSS and 35 (51%), lignocaine 1% solution. A pain score greater than 2 was considered clinically significant; 28 patients (85%) in the BSS group and 25 (71%) in the lignocaine 1% group scored 2 or less. The chi-square and Mann-Whitney tests found no significant difference between the BSS and lignocaine 1% groups (P = .30 and P = .432, respectively).

There was no significant difference in the pain scores in patients who received BSS or lignocaine 1% solution. Thus, we conclude that hydrodissecting with lignocaine 1% solution does not provide added pain relief during phacoemulsification.