Topical anesthesia using lidocaine gel for cataract surgery.

Abstract Purpose To assess the safety and efficacy of topical anesthesia using lidocaine gel in cataract surgery. Setting Department of Ophthalmology, Meir Hospital, Sapir Medical Center, Kfar-Saba, Israel. Methods One hundred cataract procedures (48 manual extracapsular cataract extraction [ECCE] and 52 phacoemulsification) were performed using lidocaine 2% gel as the sole anesthetic agent. The gel was applied 3 to 5 times prior to surgery. Intraoperative and postoperative data were recorded, and patients were asked to grade the pain on a scale of 0 (no pain) to 10 (unbearable pain). Results Sixty-two percent of patients having manual ECCE and 74% having phacoemulsification reported no pain during surgery (score 0). The mean pain score in the manual ECCE group was 0.99 ± 1.64 (SD); 3 patients required an additional intracameral lidocaine injection. The mean score in the phacoemulsification group was 0.72 ± 1.47; no patient required additional anesthesia. Conclusions Topical application using lidocaine 2% gel is safe and highly effective, especially in clear corneal phacoemulsification. The gel also provides prolonged lubrication, further facilitating surgery.