A study on the effect of topical lidocaine gel versus drops on surgeon抯 comfort during manual small incision cataract surgery

ABSTRACT

Background: Cataract is a frequent surgical procedure performed worldwide. The study compared lidocaine 4% drops with 2% gel on surgeon抯 comfort, need for supplemental anaesthesia and duration of surgery in patients who underwent manual small incision cataract surgery.Methods: This was a Prospective, Comparison study conducted at a Single centre by multiple surgeons. Patients enrolled for surgeries were divided into Group A Lidocaine 4% drops 1ml was instilled in the conjunctival sac 5 minutes before surgery and Group B Lidocaine 2% gel 2ml was applied. Endpoints evaluated were surgeon抯 comfort, need for supplemental anesthesia and duration of surgery.Results: The mean duration of surgery for gel was 20�minutes as compared to 29�minutes with drops (p*- value<0.001). 26 (87%) patients in gel did not require any supplemental anesthesia as compared to 3 (10%) patients in drops. Peribulbar supplementation was required for 20 (67%) patients in drops as compared to 1 (3%) patient in gel (p*- value<0.001). 26 (87%) patients in gel were operated comfortably by the surgeon as compared to 2 (6%) patients in drops. Mild to Moderate discomfort was experienced by the surgeon in operating 27 (90%) patients in drops as compared to 3(10%) patients in gel (p*- value<0.001).Conclusions: The surgeons were more comfortable using gel with least requirement of supplemental anaesthesia and faster completion compared to drops.