title: Cytotoxicity of lidocaine or bupivacaine on corneal endothelial cells in a rabbit model.
abstract: OBJECTIVE
  To investigate the corneal endothelial cytotoxicity of commercial formulations of agents used for intracameral anesthesia in cataract and other ocular surgery.
  
  
  METHODS
  Cultured corneal endothelial cells (CECs) of New Zealand White rabbits were exposed for 1 minute to balanced salt solution (control); Xylocaine (lidocaine) 1% E (with epinephrine), 2% E, 2%, or 4%; or Marcaine (bupivacaine) 0.5% or 0.5% spinal heavy. The degree of cytotoxicity was determined by in vitro staining with trypan blue and light microscopic evaluation of cell morphology. The effect of longer exposure (up to 16 minutes) to lidocaine 1% E was also investigated.
  
  
  RESULTS
  CECs were not significantly damaged by 1-minute exposure to lidocaine 1% E or 2% E; however, significant cytotoxicity was seen after 1-minute exposure to lidocaine 2% or 4% or bupivacaine 0.5% or 0.5% spinal heavy. Exposure to lidocaine 1% E showed a trend toward time-dependent cytotoxicity that reached significance at 16 minutes.
  
  
  CONCLUSIONS
  One-minute exposure to lidocaine 1% E or 2% E appears to be safe for cultured rabbit CECs, although longer exposures could cause time-dependent cytotoxicity, which should be considered in planning cataract or other ocular surgery. Because bupivacaine 0.5% and 0.5% spinal heavy cause cytotoxic effects within the first minute of contact with CECs, they should be used with great caution, if at all, in the anterior chamber of human eyes.
authors.affiliation: Department of Ophthalmology, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
authors.forename: Yi-Sheng
authors.initials: YS
authors.lastname: Chang
authors.forename: Shih-Ya
authors.initials: SY
authors.lastname: Tseng
authors.forename: Sung-Huei
authors.initials: SH
authors.lastname: Tseng
authors.forename: Chao-Liang
authors.initials: CL
authors.lastname: Wu
mesh_terms: D000779:Anesthetics, Local / Q000633:toxicity*; D000818:Animals; D002045:Bupivacaine / Q000633:toxicity*; D002452:Cell Count; D002470:Cell Survival; D002478:Cells, Cultured; D004305:Dose-Response Relationship, Drug; D004728:Endothelium, Corneal / Q000187:drug effects* / Q000473:pathology; D008012:Lidocaine / Q000633:toxicity*; D023421:Models, Animal; D011817:Rabbits; D013997:Time Factors
chemical_list: D000779:Anesthetics, Local; D008012:Lidocaine; D002045:Bupivacaine