Efficacy of topical plus intracameral anesthesia for cataract surgery in high myopia: randomized controlled trial.
OBJECTIVE
To assess the efficacy of intracameral lidocaine supplementation of topical anesthesia during cataract surgery in eyes with high myopia.


METHODS
Department of Ophthalmology, Ospedale San Pietro-Fatebenefratelli, Rome, Italy.


METHODS
This prospective double-blind study comprised 120 highly myopic eyes with an axial length (AL) greater than 26.0 mm scheduled for routine cataract surgery. Cases were divided into 2 groups of 60 eyes each. One group received a placebo of balanced salt solution (BSS) (control group) and the other group, a supplement of 0.1 mL preservative-free lidocaine hydrochloride 1% injected in the capsular bag during hydrodissection (lidocaine group). Intraoperative pain was assessed by recording spontaneous patient reports of sensation of pain or ocular discomfort during 3 surgical stages: phaco tip insertion, irrigation/aspiration (I/A) system insertion for cortical aspiration, I/A system insertion for ophthalmic viscosurgical device removal after intraocular lens implantation. Postoperative pain was assessed on a visual analog scale (range 0 to 10). Data were compared by chi-square and Mann-Whitney U tests.


RESULTS
The overall mean AL was 28.58 mm (28.57 mm control group; 28.50 mm lidocaine group). Fewer patients in the lidocaine group reported intraoperative pain, ocular discomfort, or tissue manipulation (odds ratio=0.36; 95% confidence interval, 0.16-0.80; P= .019). The mean postoperative pain score was 1.88+/-2.17 (SD) in the control group and 1.36+/-2.02 in the lidocaine group; the difference was not statistically significant (P= .21).


CONCLUSIONS
Intracameral lidocaine supplementation for cataract surgery may improve intraoperative comfort under topical anesthesia in highly myopic eyes.
Lofoco
Giorgio
G
San Pietro Fatebenefratelli Hospital, Rome, Italy.
Ciucci
Francesco
F
Bardocci
Antonio
A
Quercioli
Pierpaolo
P
De Gaetano
Cristiano
C
Ghirelli
Giorgio
G
Perdicaro
Serenella
S
Schiano Lomoriello
Domenico
D
Cacciamani
Andrea
A
D000287:Administration, Topical; D000368:Aged; D000772:Anesthesia, Local / Q000379:methods*; D000779:Anesthetics, Local / Q000008:administration & dosage*; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D007903:Lens Capsule, Crystalline / Q000187:drug effects*; D019654:Lens Implantation, Intraocular; D008012:Lidocaine / Q000008:administration & dosage*; D008297:Male; D008875:Middle Aged; D047728:Myopia, Degenerative / Q000150:complications*; D010147:Pain Measurement; D010149:Postoperative Pain; D018918:Phacoemulsification; D011446:Prospective Studies; D016896:Treatment Outcome
D000779:Anesthetics, Local; D008012:Lidocaine