Efficacy of supplementary intracameral lidocaine in routine phacoemulsification under topical anesthesia

Ophthalmology. 1999 Nov;106(11):2173-7. doi: 10.1016/S0161-6420(99)90501-8.


Objective: To determine whether the routine use of supplementary intracameral lidocaine has any benefit over topical anesthesia alone when performing phacoemulsification surgery.

Design: A prospective single-center, randomized, double-masked, clinical trial.

Participants: A total of 204 patients undergoing phacoemulsification surgery with lens implantation under planned topical anesthesia.

Methods: 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.

Main outcome measures: 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.

Results: 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).

Conclusions: In this study, the routine use of intracameral lidocaine as a supplement to topical anesthesia was shown not to have a clinically useful role.

Publication types

  • Clinical Trial
  • Randomized Controlled Trial

MeSH terms

  • Aged
  • Aged, 80 and over
  • Anesthesia, Local / methods*
  • Anesthetics, Combined / administration & dosage*
  • Anesthetics, Local / administration & dosage*
  • Anterior Chamber / drug effects*
  • Capsulorhexis
  • Double-Blind Method
  • Female
  • Humans
  • Lens Implantation, Intraocular
  • Lidocaine / administration & dosage*
  • Male
  • Middle Aged
  • Pain / prevention & control
  • Pain Measurement
  • Phacoemulsification*
  • Prospective Studies
  • Tetracaine / administration & dosage*


  • Anesthetics, Combined
  • Anesthetics, Local
  • Tetracaine
  • Lidocaine