Topical anesthesia using lidocaine gel for cataract surgery

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.