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Topical anesthetic gel decreases pain in LASIK

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NUSA DUA, Indonesia — A topical lidocaine 2% gel applied to eyes before LASIK helps mitigate pain more than conventional treatment, both intraoperatively and postoperatively, according to one researcher here.

Philip Lam

While LASIK results in less pain than surface ablation procedures, some patients may still experience enough pain in LASIK surgery that it can result in complications, Philip Lam, MD, said in a presentation at the joint meeting of the Asia-Pacific Academy of Ophthalmology and American Academy of Ophthalmology.

Asian patients in particular experience pain in LASIK mostly from speculum placement and the microkeratome pass, he said.

Dr. Lam and colleagues at the Chinese University of Hong Kong performed a prospective, double-blind, randomized, controlled, clinical trial comparing Xylocaine (lidocaine HCl, AstraZeneca) gel with the conventional treatment of Alcaine (proparacaine hydrochloride, Alcon) topical drops.

"We hypothesized that Xylocaine gel is a better anesthetic agent than Alcaine eye drops for LASIK as it coats both the ocular surface and the lid regions better and has a longer duration of action," Dr. Lam said.

The study of 33 patients showed a significant reduction of pain scores at 15, 30 and 45 minutes after LASIK compared with standard anesthetic drop treatment.

"The study results showed supplementary use of Xylocaine gel could effectively reduce both intraoperative and perioperative pain arising from LASIK," Dr. Lam said. "Larger-scale studies appear warranted."