Unpreserved lidocaine to control discomfort during cataract surgery using topical anesthesia

J Cataract Refract Surg. 1997 May;23(4):545-50. doi: 10.1016/s0886-3350(97)80211-8.


Purpose: To determine whether intraoperative unpreserved lidocaine further decrease discomfort or pain during sutureless small incision cataract surgery and intraocular lens (IOL) implantation under topical anesthesia.

Setting: Outpatient ambulatory surgical center.

Methods: In this prospective controlled study, comparable eligible patients were randomized to receive 0.1 cc unpreserved lidocaine 1% or 0.1 cc balanced salt solution (BSS) (control group) in double-masked fashion. Study drugs were injected intracamerally 1 minute before phacoemulsification. A predefined uniform pain/discomfort scale was used for assessment during phacoemulsification and IOL insertion. A secondary study using a 0.5 cc dose was also performed.

Results: Twenty-six percent in the control group and 9% in the lidocaine group had discomfort pain scores of 2 or more; 10% in the BSS group felt increased pressure or pain during phacoemulsification. In the lidocaine group, discomfort was felt mainly during IOL insertion, possibly as a result of wound manipulation. During phacoemulsification, no patient in the lidocaine group reported pain; 2% felt increased pressure during phacoemulsification. A dose increase to 0.5 cc reduced any intraocular sensation to 3% in the lidocaine group. No patient in either group had significant cell loss or adverse events.

Conclusion: Intraoperative lidocaine is safe and effective in controlling intraoperative discomfort.

Publication types

  • Clinical Trial
  • Randomized Controlled Trial

MeSH terms

  • Aged
  • Aged, 80 and over
  • Anesthetics, Local / administration & dosage
  • Anesthetics, Local / therapeutic use*
  • Cataract Extraction*
  • Dose-Response Relationship, Drug
  • Double-Blind Method
  • Female
  • Humans
  • Intraoperative Period
  • Lidocaine / administration & dosage
  • Lidocaine / therapeutic use*
  • Male
  • Middle Aged
  • Palliative Care*
  • Phacoemulsification
  • Prospective Studies


  • Anesthetics, Local
  • Lidocaine