Tetracaine 0.5% eyedrops with or without lidocaine 2% gel in topical anesthesia for cataract surgery

Anthoula T Tsoumani^1,2, Ioannis C Asproudis¹, Dimitrios Damigos^2
1Department of Ophthalmology University Hospital of Ioannina, ²Department of Medical Psychology, Postgraduate Course of “Pain Management”, University of Ioannina, Greece

Background and objective: To evaluate the level of pain during phacoemulsification and foldable intraocular lens implantation under instillation of tetracaine 0.5% eyedrops versus a combination of lidocaine 2% gel and instillation of tetracaine eyedrops.

Methods: This prospective, randomized, controlled study included 51 patients undergoing phacoemulsification under topical anesthesia. They were randomized into two groups based on the topical anesthetic method they were to receive. Preoperatively all patients were asked to answer a questionnaire. One hour postoperatively, they were asked to grade their intraoperative and postoperative pain on a visual analog scale from 0 to 10.

Results: There were no statistically significant differences between the two methods of anesthesia. Gender and the presence of relatives or friends were independent factors playing a significant role in pain sensitivity.

Conclusions: The combination of lidocaine 2% gel and tetracaine eyedrops does not have a better analgesic result than a single instillation of tetracaine 0.5% eyedrops.

Keywords: ophthalmic pain, cataract, phacoemulsification, tetracaine eyedrops, lidocaine gel, topical anesthesia