Systemic levels of lidocaine after intracameral injection during cataract surgery

Purpose: To evaluate the systemic concentrations of lidocaine after intraca meral injection of a 1% solution during cataract surgery and the safety of this application mode. Setting: Department of Ophthalmology, Medical University of Lubeck, Lubeck, Germany Methods: This prospective study included 10 patients who had phacoemulsific ation and posterior chamber lens implantation with a self-sealing scleral t unnel incision. Topical anesthesia was achieved using cocaine 10% eyedrops combined with 0.5mL of unpreserved lidocaine 1% injected into the anterior chamber. Blood samples were taken from all patients at predetermined interv als before and during the procedure. Consecutive analysis for lidocaine was performed with gas chromatography. Results: In all samples, serum lidocaine concentrations were below a minimu m detectable level of 100 ng/mL. No local or systemic intraoperative or pos toperative complications were noted. Conclusions: Intracameral injection of 0.5 mL lidocaine 1% revealed no syst emic therapeutic concentrations. In patients in whom other forms of needle- delivered local anesthesia are contraindicated, intracameral injection of l idocaine should be considered to enhance topical anesthesia. J Cataract Ref ract Surg 1999; 25:648-651 (C) 1999 ASCRS and ESCRS.