Combined lidocaine 1% and hydroxypropyl methylcellulose 2.25% as a single anesthetic/ viscoelastic agent in phacoemulsification.
OBJECTIVE
To evaluate the use of a mixture of hydroxypropyl methylcellulose 2.25% (HPMC) and lidocaine 1% (final concentrations) as a single viscoelastic/anesthetic agent to achieve proper anesthesia and viscoelastic properties during phacoemulsification.


METHODS
Department of Ophthalmology, Cairo University, Cairo, Egypt.


METHODS
This prospective randomized study comprised 70 eyes having routine phacoemulsification. Patients had the HPMC-lidocaine mixture (n = 35) or pure HPMC 2.25% (n = 35) injected before capsulorhexis and again before intraocular lens implantation. The results were evaluated by a pain/discomfort score postoperatively.


RESULTS
The difference in medians of the overall intraoperative pain/discomfort scores between the 2 groups was not statistically significant. However, mild pain/discomfort was reported by 60.0% in the pure HPMC group and by 31.4% in the HPMC-lidocaine mixture group. Moderate pain/discomfort was reported by 28.6% and 5.7%, respectively. The difference between the 2 groups was statistically significant (P =.001).


CONCLUSIONS
The use of a mixture of HPMC 2.25% and lidocaine 1% rather than a regular viscoelastic agent resulted in clinically and statistically significantly reduced pain/discomfort during phacoemulsification.
Hosny
Mohamed
M
Department of Ophthalmology, Cairo University, Cairo, Egypt. gozreem@hotmail.com
Eldin
Sherif Gamal
SG
Hosny
Hisham
H
D000328:Adult; D000772:Anesthesia, Local / Q000379:methods; D000779:Anesthetics, Local / Q000008:administration & dosage*; D019923:Capsulorhexis; D004359:Drug Therapy, Combination; D006801:Humans; D007785:Lactose / Q000008:administration & dosage* / Q000031:analogs & derivatives*; D019654:Lens Implantation, Intraocular; D008012:Lidocaine / Q000008:administration & dosage*; D008747:Methylcellulose / Q000008:administration & dosage* / Q000031:analogs & derivatives*; D010078:Oxazines; D010147:Pain Measurement; D017060:Patient Satisfaction; D018918:Phacoemulsification; D011446:Prospective Studies
D000779:Anesthetics, Local; D010078:Oxazines; D008747:Methylcellulose; D008012:Lidocaine; C071191:MK 458; D007785:Lactose