A randomized controlled trial of intracameral lidocaine during phacoemulsification under topical anesthesia

Objective: To test the hypothesis that adjunctive intracameral 1% lidocaine reduces intraoperative pain during phacoemulsification using topical anesthesia. Design: Prospective, double-masked, randomized, controlled trial. Participants: A total of 200 patients undergoing routine phacoemulsification under topical 1% tetracaine were studied. Intervention: Randomization to 0.5 ml intracameral, unpreserved, epinephrine-free 1% lidocaine or placebo was conducted. Main Outcome Measure: Intraoperative pain was quantified by the patients using a 0-10 visual analog pain scale. Results: Intraoperative pain scores (+/- standard deviation) for the lidocaine and control groups were 1.29 +/- 1.24 and 1.44 +/- 1.33, respectively (P > 0.35). Conclusions: In a rigorously double-masked, prospective, randomized, controlled trial there was no significant reduction in intraoperative pain when intracameral 1% lidocaine was used during phacoemulsification under topical anesthesia. Ophthalmology 2000;107:68-71 (C) 2000 by the American Academy of Ophthalmology.