Ocular toxicity following topical application of anesthetic cream to the eyelid skin.
OBJECTIVE
The use of topical anesthetic cream in the periorbital region may be of clinical value. The potential for toxic effects from such use has not been studied in a controlled manner. This study was performed to evaluate the potential ocular toxicity of anesthetic cream topically applied to the eyelid in an animal model.


METHODS
Ten rabbits underwent periorbital eutectic mixture of local anesthetics (EMLA) (2.5 percent lidocaine and 2.5 percent prilocaine) application and were observed for evidence of gross or microscopic ocular toxicity. Baseline external and anterior segment examinations were performed, including biomicroscopy and fluorescein staining, after which a standard quantity of EMLA cream (0.75 g) was applied along the upper eyelid and covered with an occlusive dressing. After 1 hour of treatment, the eyelid and anterior segment were examined for evidence of adverse reaction. The eyelids were excised and examined histopathologically.


RESULTS
No significant adverse effects were noted on external lid and anterior segment examination. The histopathologic findings were within normal limits.


CONCLUSIONS
This study suggests that external application of EMLA cream to the eyelid does not induce local toxicity in the rabbit model. The external application of EMLA cream may be safe in the periorbital region.
Cohen
R G
RG
New England Eye Center, Tufts University School of Medicine, Boston, MA, USA.
Hartstein
M
M
Lahav
M
M
Woog
J J
JJ
Ladav
M
M
D000287:Administration, Topical; D000779:Anesthetics, Local / Q000008:administration & dosage / Q000633:toxicity*; D000818:Animals; D000869:Anterior Eye Segment / Q000187:drug effects* / Q000473:pathology; D004338:Drug Combinations; D004353:Drug Evaluation, Preclinical / Q000379:methods; D005143:Eyelids / Q000187:drug effects* / Q000473:pathology; D008012:Lidocaine / Q000008:administration & dosage / Q000633:toxicity*; D000077442:Lidocaine, Prilocaine Drug Combination; D009824:Ointments / Q000008:administration & dosage / Q000633:toxicity*; D011318:Prilocaine / Q000008:administration & dosage / Q000633:toxicity*; D011817:Rabbits; D012449:Safety
D000779:Anesthetics, Local; D004338:Drug Combinations; D000077442:Lidocaine, Prilocaine Drug Combination; D009824:Ointments; D011318:Prilocaine; D008012:Lidocaine