Comparative efficacy of topical tetraVisc versus lidocaine gel in cataract surgery.
BACKGROUND
To compare the clinical efficacy of lidocaine 2% with tetracaine 0.5% for cataract surgery.


METHODS
In a randomized, multi-surgeon, controlled clinical trial,122 consecutive cataract cases eligible for topical anesthesia, were randomly assigned to receive lidocaine 2% gel (1 ml) or tetracaine solution 0.5% (TetraVisc, 0.5 ml) before clear corneal phacoemulsification. Main outcome measure was visual analog scale (0 to 10), which was used to measure intra-operative pain. Secondary outcome measures included patients' discomfort due to tissue manipulation and surgeon graded patients' cooperation. Duration of surgery and intra-operative complications were also recorded.


RESULTS
The mean age in TetraVisc (TV) group was 70.4 years and in the lidocaine gel group (LG) it was 70.6 years (p = 0.89). Patient reported mean intra-operative pain scores by visual analog scale were 0.70 +/- 0.31 in TV group and 1.8 +/- 0.4 in LG group (P < 0.001). Mean patient cooperation was also marginally better in the TV group (8.3 +/- 0.3) compared to LG group (8.4 +/- 0.6) (P = 0.25). 96% of patients in TV group showed intra-operative corneal clarity compared to 91% in LG group. TV group had less (1 out of 61 patients, 1.6%) intra-operative complications than LG group (3 out of 61 patients, 4.8%). No anesthesia related complications were noted in either group


CONCLUSIONS
Topical TetraVisc solution was superior to lidocaine 2% gel for pain control in patients undergoing clear corneal phacoemulsification. Lidocaine 2% gel is similar to TetraVisc in patient comfort and surgeon satisfaction.


BACKGROUND
Clinical trials number: ISRCTN78374774.
Chalam
K V
KV
Department of Ophthalmology, University of Florida College of Medicine, Jacksonville, Florida, USA. kvchalam@aol.com
Murthy
Ravi K
RK
Agarwal
Swati
S
Gupta
Shailesh K
SK
Grover
Sandeep
S
D000287:Administration, Topical; D000368:Aged; D000369:Aged, 80 and over; D000779:Anesthetics, Local / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D019654:Lens Implantation, Intraocular / Q000379:methods; D008012:Lidocaine / Q000008:administration & dosage*; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000188:drug therapy; D010147:Pain Measurement; D010349:Patient Compliance; D018918:Phacoemulsification / Q000379:methods*; D013748:Tetracaine / Q000008:administration & dosage*
D000779:Anesthetics, Local; D013748:Tetracaine; D008012:Lidocaine
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