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

Abstract 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.