The Effects of Unpreserved Lidocaine on the Corneal Endothelium during Cataract Surgery

ABSTRACT

Recently, intracameral injection of 1% unperserved lidocaine was intro-duced as a supplement to the topical anesthesia in cataract operations. We evaluated the effect of intracameral lidocaine on the corneal endothelium. One hundred eyes of 90 patients undergone scleral tunnel incision and phacoemulsification with posterior chamber intraocular lens implantation were divided into 2 group according to the methods of anesthesia. Topical anesthesia with intracameral injection of 0.2 of 1% unpreserved lidocaine was used to the 50 eyes of 45 patients[group 1] and pinpoint anestesia to the rest[group 2]. Specular microscopy using non-contact specular microscope was done preoperatively, 1 week, 1 month and 3 months postoperatively to compare the endothelial morphologic changes between the 2 groups. The reduction of central corneal endothelial cell density at 3 months postoperatively was 9.45% in Group 1 and 8.74% in Group 2. The difference between the 2 groups was not significant statistically[p>0.1]. Postoperative changes in coefficient of variation[polymegathism] and hexagonality[pleomorphism] were not significantly different between the 2 groups either[p>0.1]. We therefore concluded that intracameral injection of 1% unpreserved lidocaine does not adversely affect the corneal endothelial cell function and morphology and may safely be used as a supplement to topical anesthesia in cataract surgeries.