Efficacy of supplementary intracameral lidocaine in routine phacoemulsification under topical anesthesia

To determine whether the routine use of supplementary intracameral lidocaine has any benefit over topical anesthesia alone when performing phacoemulsification surgery. A prospective single-center, randomized, double-masked, clinical trial. A total of 204 patients undergoing phacoemulsification surgery with lens implantation under planned topical anesthesia. Patients were randomly allocated to receive either topical anesthesia plus 0.5 ml intracameral balanced salt solution or topical anesthesia plus 0.5 ml preservative-free 1% intracameral lidocaine. On the day after surgery, patients were asked to document the discomfort they had experienced using a visual analog scale. Intraoperative discomfort, postoperative discomfort, and discomfort caused by the microscope light were assessed. Multiple linear regression analysis did not show any significant relationship between the use of intracameral lidocaine and either intraoperative ( P = 0.34) or postoperative ( P = 0.45) pain scores. There was a small reduction in the discomfort caused by the operating microscope when intracameral lidocaine was used ( P = 0.04). In this study, the routine use of intracameral lidocaine as a supplement to topical anesthesia was shown not to have a clinically useful role.