Weindler J.

Augen-Praxisklinik, Neckarstr. 71, 73728 Esslingen

Along with progress in surgical techniques and the ensuing reduction of both operation time and trauma also anesthesiological procedures experience modification in cataract surgery. In recent years and in contrast to previous techniques based on injection various topical methods are being used increasingly. The aim of this study was to investigate whether topical anesthesia using cocaine eye drops or lidocaine gel is the more effective analgesic for cataract surgery.
Methods: In a prospective, randomized, and double masked investigation 40 patients each received cocaine eye drops 10% (group A) or lidocaine gel 2% preoperatively for topical anesthesia. Patients with preoperative pain, intraocular infection, intraocular pressure of more than 25 mmHg, known glaucoma as well as patients with limited ability to cooperate were excluded from the study. As a premedication all patients received oral Midazolam 3.75 mg. In all patients we implanted the intraocular lens via a postlimbal clear corneal incision using an injector. All operations were performed by the same surgeon.
Results: Biometric data of both groups was very comparable. The previously mentioned pain score was very low in both groups, more specifically 1,0 in group A und 0,94 in group B. In that respect we were unable to find significant differences between the two sets of patients. Approximately 5 % feel strong pain with a score beyond 3. In no patient it was necessary to re-inject intraoperatively to complete anesthesia.
Conclusion: In agreement with other research on topical anesthesia in ophthalmology our results demonstrate as well that cocaine eye drops and lidocaine gel can be successfully used in cataract surgery. So far, the effectiveness of the various applied topical anesthesiological approaches is widely comparable.

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