The Effectiveness of 2% Lidocaine Gel Compared to 0.5% Tetracaine Eye Drop As Topical Anesthetic Agent for Phacoemulsification Surgery

Abstract

BackgroundTopical anesthetics have become the primary choice in phacoemulsification procedures for cataract extraction. The most common topical anesthetic drug used is 0.5% tetracaine eye drops. Repeated administration of 0.5% tetracaine drops can cause corneal epithelial damage. Two percent lidocaine gel is latest option which has longer contact time with corneal epithelium.ObjectivesTo compare the effectiveness of 2% lidocaine gel with 0.5% tetracaine drops in phacoemulsification surgery.MethodsThe study was a single blinded randomized clinical trial from March to July 2017 in patients underwent phacoemulsification cataract surgery. There were 72 subjects with age ≥ 40 years old who received randomization and divided into 2 groups: 2% lidocaine gel group and 0.5% tetracaine eye drop group. Topical anesthetics were applied 5 minutes before surgery. Five minutes after surgery, pain scale perceived during surgery was assessed by using a numerical rating scale. At the end of surgery, the subject filled the satisfaction questionnaire on topical anesthetic drugs administered. The ophthalmologists were also given a satisfactory questionnaire for topical anesthetic drugs selected for the procedure.ResultsThe median pain scale for 2% lidocaine gel group pain scale was 1; meanwhile, the median pain scale for 0.5% tetracaine eye drops was 3 (P < 0.05).ConclusionsTwo percent lidocaine gel was more effective in relieving pain during phacoemulsification cataract surgery compared with 0.5% tetracaine drops.

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“…The dose of lidocaine used for the topical anesthesia in the cataract surgery was 2% [ 59 ]. 2% gel of lidocaine was also proposed as the topical anesthetic agent for phacoemulsification surgery [ 60 ]. In the presented study, the concentration of L in formulations F4–F6 was also 2%.…”

Vitreoretinal Surgery Under Sub-Tenon’s Block and Conscious Sedation in a Patient with Brugada Syndrome: A Case Report and Literature Review

“…Three cataract extractions were reported under topical anesthesia using oxybuprocaine eye drops. Moreover, 2% lidocaine gel has been used effectively during phacoemulsification cataract surgery ( 11 ). Lidocaine in patients with BrS has been shown to be safe during local dental anesthesia, even when combined with adrenaline.…”

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“…Application of topical sevoflurane to the ulcer at a dose of 1 ml per cm 2 of ulcer area was shown to induce analgesic effects in 2 to 7 minutes (45). This, compared to the analgesic onset of lidocaine and prilocaine, which ranges from 30 to 40 minutes, is significantly faster (42,50).…”