Efficacy of topical plus intracameral anesthesia for cataract surgery in high myopia

Randomized controlled trial

Giorgio Lofoco, Francesco Ciucci, Antonio Bardocci, Pierpaolo Quercioli, Cristiano De Gaetano, Giorgio Ghirelli, Serenella Perdicaro, Domenico Schiano Lomoriello, Andrea Cacciamani

Research output: Contribution to journalArticle

11 Citations (Scopus)

Abstract

Purpose: To assess the efficacy of intracameral lidocaine supplementation of topical anesthesia during cataract surgery in eyes with high myopia. Setting: 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). Conclusion: Intracameral lidocaine supplementation for cataract surgery may improve intraoperative comfort under topical anesthesia in highly myopic eyes.

Original languageEnglish
Pages (from-to)1664-1668
Number of pages5
JournalJournal of Cataract and Refractive Surgery
Volume34
Issue number10
DOIs
Publication statusPublished - Oct 2008

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Myopia
Lidocaine
Cataract
Anesthesia
Randomized Controlled Trials
Postoperative Pain
Pain
Control Groups
Eye Axial Length
Device Removal
Intraocular Lens Implantation
Ophthalmology
Nonparametric Statistics
Visual Analog Scale
Double-Blind Method
Italy
Salts
Odds Ratio
Placebos
Confidence Intervals

ASJC Scopus subject areas

  • Ophthalmology

Cite this

Efficacy of topical plus intracameral anesthesia for cataract surgery in high myopia : Randomized controlled trial. / Lofoco, Giorgio; Ciucci, Francesco; Bardocci, Antonio; Quercioli, Pierpaolo; De Gaetano, Cristiano; Ghirelli, Giorgio; Perdicaro, Serenella; Lomoriello, Domenico Schiano; Cacciamani, Andrea.

In: Journal of Cataract and Refractive Surgery, Vol. 34, No. 10, 10.2008, p. 1664-1668.

Research output: Contribution to journalArticle

Lofoco, Giorgio ; Ciucci, Francesco ; Bardocci, Antonio ; Quercioli, Pierpaolo ; De Gaetano, Cristiano ; Ghirelli, Giorgio ; Perdicaro, Serenella ; Lomoriello, Domenico Schiano ; Cacciamani, Andrea. / Efficacy of topical plus intracameral anesthesia for cataract surgery in high myopia : Randomized controlled trial. In: Journal of Cataract and Refractive Surgery. 2008 ; Vol. 34, No. 10. pp. 1664-1668.
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abstract = "Purpose: To assess the efficacy of intracameral lidocaine supplementation of topical anesthesia during cataract surgery in eyes with high myopia. Setting: 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). Conclusion: Intracameral lidocaine supplementation for cataract surgery may improve intraoperative comfort under topical anesthesia in highly myopic eyes.",
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T1 - Efficacy of topical plus intracameral anesthesia for cataract surgery in high myopia

T2 - Randomized controlled trial

AU - Lofoco, Giorgio

AU - Ciucci, Francesco

AU - Bardocci, Antonio

AU - Quercioli, Pierpaolo

AU - De Gaetano, Cristiano

AU - Ghirelli, Giorgio

AU - Perdicaro, Serenella

AU - Lomoriello, Domenico Schiano

AU - Cacciamani, Andrea

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N2 - Purpose: To assess the efficacy of intracameral lidocaine supplementation of topical anesthesia during cataract surgery in eyes with high myopia. Setting: 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). Conclusion: Intracameral lidocaine supplementation for cataract surgery may improve intraoperative comfort under topical anesthesia in highly myopic eyes.

AB - Purpose: To assess the efficacy of intracameral lidocaine supplementation of topical anesthesia during cataract surgery in eyes with high myopia. Setting: 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). Conclusion: Intracameral lidocaine supplementation for cataract surgery may improve intraoperative comfort under topical anesthesia in highly myopic eyes.

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