EMLA Cream-Induced Eye Injury

Comparison of Lidocaine Gel–Assisted Transconjunctival and Transcutaneous Local Anesthesia for Outpatient Eyelid Surgery

“…7 However, subsequent case reports Transconjunctival Local Anesthesia demonstrated lidocaine/prilocaine cream that may come in contact with the ocular surface during application could cause corneal de-epithelialization due to its alkali pH. 8,9 Lidocaine gel applied to the ocular surface has been used for over a decade with an excellent safety profile. 5,10-16 The advantage of eyelid surgery is that there is a moist mucous membrane lining the posterior lamella, which can be used to absorb lidocaine gel and allow for a robust anesthetic effect.…”

“…As seen with lidocaine/prilocaine cream, these anesthetics must first be proven to be safe for ocular use. [7][8][9] Preliminary toxicity studies in 1999 found 2% lidocaine gel to have no significant toxicity to the ocular surface. 10,11 Advances in cataract surgery have allowed the safe use of 2% lidocaine gel for over a decade now.…”

Ulceration of gingival mucosa after topical application of EMLA: report of four cases

“…Besides the bitter taste, the strong alkalinity has been pointed out as the probable cause of the eye injuries, mainly due to saponifi cation of tissues. 18 The use of EMLA is also a matter of concern due to the presence of prilocaine, which can induce methaemoglobinae mia, as reported by the manufacturer. There are an increasing number of methaemoglobinaemia cases reported in the literature caused by EMLA, espe cially in children undergoing small skin surgeries.…”

Local Anesthesia: Evidence, Strategies, and Safety

“…EMLA is considered pregnancy class B and caution should be used in breastfeeding as lidocaine is excreted in breast milk. Ocular exposure should be avoided due to the presence of sodium hydroxide and the potential for alkaline injury [32].…”