Mp. Pang et al., Pain, photophobia, and retinal and optic nerve function after phacoemulsification with intracameral lidocaine, OPHTHALMOL, 108(11), 2001, pp. 2018-2025
Objective: To evaluate differences in pain, photophobia, retinal and optic
nerve function in test eyes given intracameral lidocaine compared with cont
rol eyes given intracameral saline after phacoemulsification under topical
anesthesia.
Design: Prospective paired-eye intervention study with random treatment all
ocation.
Participants: Thirty eyes of 15 patients underwent cataract surgery in both
eyes under topical anesthesia.
Intervention: The first eye of each patient was randomly assigned to either
0.5 ml preservative-free 2% intracameral lidocaine or 0.5 ml of intracamer
al sterile saline. Within 5 months, the second eye automatically received i
ntracameral saline if the first eye received intracameral lidocaine or vice
versa.
Main Outcome Measures. The duration of surgery was recorded. Immediately af
ter surgery, each patient was asked to evaluate the degree of pain and phot
ophobia experienced during surgery using a nominal scale. In addition, in f
ive patients, electroretinography (ERG) and visual evoked response (VER) we
re performed within I week before surgery, immediately after surgery, and 1
day after surgery. Amplitudes and latencies were calculated.
Results: There was no difference in the duration of surgery comparing test
eyes given intracameral lidocaine with control eyes given. sterile saline (
P=0.81). There was no significant difference in the level of pain reported
when. comparing test eyes given intracameral lidocaine with control, eyes (
P=1.00). None of the, patients reported any significant difference in photo
phobia between their two eyes (P=1.00). When comparing ERG measurements, te
st eyes, given intracameral lidocaine did not show any significant decrease
in ERG amplitudes, or prolonged latencies compared with control eyes. When
comparing VER measurements, test eyes given intracameral lidocaine did not
show any increase in P1 latencies compared with control eyes (P=0.31). Whe
n evaluating all postoperative ERG results 1 day after surgery, there was a
suggestion of improved cone function.
Conclusions: Although intracameral lidocaine does not depress retinal or op
tic nerve function, the addition: of intracameral lidocaine to topical anes
thesia during phacoemulsification does not significantly reduce intraoperat
ive pain or photophobia. Ophthalmology 2001;108:2018-2025 (C) 2001 by the A
merican Academy of Ophthalmology.