[Intracameral lidocaine and phacoemulsification under topical anesthesia. Apropos of 80 operations].
OBJECTIVE
To evaluate the advantage of intracameral unpreserved lidocaine for patient comfort during phacoemulsification under topical anesthesia.


METHODS
In this prospective study, we performed 80 phacoemulsifications under topical anesthesia, with tetracaine 1% drops, 10 minutes before and at the start of surgery: 40 patients received 0.3 cc balanced salt solution (BSS) intracameral injection; 40 patients received 0.3 cc unpreserved lidocaine 1% intracameral injection. The same surgical procedure was performed in both groups: 3.2 mm temporal corneal self-sealing incision, capsulorhexis, foldable polyHEMA IOL implantation into the capsular bag. There was no intravenous sedation.


RESULTS
Forty-eight percent (19) in the BSS group and 70% (28) in the lidocaine group felt no pain. 10% (4) in the BSS group reported sharp pain during phacoemulsification. During IOL insertion, no pain was reported by 48% (19) in the BSS group, and 75% (30) in the lidocaine group; 10% (4) in the BSS group felt severe pain (significant difference: p < 0.05). Endothelial cell loss was 6% in the BSS group, and 6.4% in the lidocaine group (non significant difference).


CONCLUSIONS
Intracameral lidocaine is safe and effective in decreasing discomfort among patients undergoing phacoemulsification under topical anesthesia.
Clinique d'Ophtalmologie, Hôpital d'Instruction des Armées du Val-de-Grâce, Paris.
L
L
Roux
J C
JC
Rigal-Sastourné
F
F
Bidaux
F
F
May
J P
JP
Renard
J F
JF
Maurin
D000287:Administration, Topical; D000368:Aged; D000369:Aged, 80 and over; D000772:Anesthesia, Local; D000779:Anesthetics, Local / Q000008:administration & dosage*; D000867:Anterior Chamber; D014151:Anti-Anxiety Agents / Q000008:administration & dosage; D003519:Cyclopentolate / Q000008:administration & dosage; D005260:Female; D006801:Humans; D006919:Hydroxyzine / Q000008:administration & dosage; D007267:Injections; D007431:Intraoperative Complications / Q000517:prevention & control; D008012:Lidocaine / Q000008:administration & dosage*; D008297:Male; D008875:Middle Aged; D009184:Mydriatics / Q000008:administration & dosage; D010149:Postoperative Pain / Q000517:prevention & control; D018918:Phacoemulsification / Q000379:methods*; D011229:Preanesthetic Medication; D011446:Prospective Studies; D013748:Tetracaine; D016896:Treatment Outcome
D000779:Anesthetics, Local; D014151:Anti-Anxiety Agents; D009184:Mydriatics; D013748:Tetracaine; D006919:Hydroxyzine; D008012:Lidocaine; D003519:Cyclopentolate
Lidocaïne intracamérulaire et phacoémulsification sous anesthésie topique. A propos de 80 interventions.