Supplementary intracameral anesthesia may reduce pain during phaco, meta-analysis suggests

Supplementary intracameral lidocaine may reduce intraoperative pain during cataract surgery when used in conjunction with topical anesthetic, according to a study by researchers in the United Kingdom. However, due to the diversity of outcome measures among different randomized controlled trials, the potential for intracameral lidocaine causing adverse effects has yet to be clinically tested.

"Although a statistically significant reduction in intraoperative pain has been demonstrated, it is not yet possible to recommend this additional intervention without reservations," the authors said.

Daniel G. Ezra, MA, MRCOphth, and colleagues at Moorfields Eye Hospital conducted a meta-analysis of eight randomized controlled trials, including a total of 1,281 participants, comparing the effects of administering combined topical and intracameral anesthesia with topical anesthesia alone for patients during phacoemulsification for cataract.

Specifically, the researchers compared self-reported intraoperative pain, adverse events and complications resulting from both anesthesia options, as well as the incidence and necessity of additional perioperative anesthesia.

The meta-analysis showed significantly lower perceived intraoperative pain among patients using supplementary intracameral lidocaine, the authors noted.

"No significant difference in intraoperative adverse events, corneal toxicity or the need for supplemental anesthesia was identified," they said.

The study is published in the March issue of Ophthalmology.