Intracameral lidocaine reduces pain in cataract surgery, but only a little bit

To assess the effectiveness of intracameral lidocaine during routine cataract surgery.

Prospective, single-blinded, randomized, controlled trial.

Adult patients undergoing routine phacoemulsification cataract extraction in a chartered surgical facility in Edmonton, Alberta, Canada, were enrolled in the study.

Patients were randomized to receive intracameral lidocaine or control (intracameral balanced salt solution). Patients rated their pain at the time of intracameral injection and at the conclusion of the surgery, on a scale from 0 to 10.

The study included 106 eyes from 82 patients. The overall pain score was lower (p = 0.004) in the lidocaine group (0.43 ± 0.94/10) than in the control group (0.72 ± 2.79/10). Pain was higher (p = 0.002) in more myopic (1.80 ± 4.04/10) than less myopic patients (0.50 ± 1.67/10). There was no difference in pain experienced at the time of injection (p = 0.270). There was no difference in same-day postoperative logMAR visual acuity (p = 0.837).

Intracameral lidocaine reduces pain during cataract surgery, but the effect is small; it is most effective in myopic patients.