Topical Use of Ropivacaine 1% vs Lidocaine 2% in Cataract Surgery

Abstract

Abstract: : Purpose: to evaluate the different efficacy and tollerability of topical anesthesia with ropivacaine 1% vs lidocaine 2% in cataract surgery. Methods: 63 patients, included in this study (age range 52–85 years), were randomized to group I (n 33) or group II (n 30). Phacoemulsification cataract surgery was performed in group I with ropivacaine 1% while in group II with lidocaine 2%. We evaluated pain during surgery with the VAS (visual analogical scale: absent, low, moderate, severe); the endothelial cell density before and after surgery; any other additional intraoperative intracameral anesthesia. Results: in all two groups no patient needed systemic sedation; no differences in total of drops used were recorded. Ropivacaine 1% was more effectiveness respect to lidocaine 2% because the VAS was significantly higher in group II than in group I (p>0.05). The mean endothelial cell density decreased in group I from 2234 cells/mm² ± 234 (SD) to 2105 cells/mm² ± 321 (SD), while in group II from 2180 cells/mm² ± 332 (SD) to 2015 cells/mm² ± 436 (SD). Only five patients in lidocaine group needed an additional intracameral anesthesia. Conclusions: Ropivacaine 1% was slightly more effectiveness than lidocaine 2% as local anesthetic agent. In ropivacaine 1% group nobody required any additional intraoperative anesthetic; best comfortable operative conditions in group I than in group II were recorded. No statistically different mean endothelial cell density loss was noted in all two groups.

Keywords: cataract • microscopy: confocal/tunneling • anterior segment