Comparative study of topical anaesthesia with lidocaine 2% vs levobupivacaine 0.75% in cataract surgery

Abstract

Background. This study compared the efficacy of topical anaesthesia with levobupivacaine 0.75% vs lidocaine 2% during cataract surgery by phacoemulsification. Methods. A prospective, randomized, double-blind study comparing two agents for topical anaesthesia in cataract surgery. Two hundred and forty-six consecutive patients undergoing corneal phacoemulsification were enrolled into two groups to receive either topical levobupivacaine 0.75% (n=126) or lidocaine 2% (n=120). The main outcome variables of the study were intraoperative and postoperative pain, requirement for additional anaesthesia, patient comfort and cooperation, surgeon satisfaction, and corneal epithelial toxicity induced by topical drugs. Results. Levobupivacaine 0.75% provided significantly better analgesia than lidocaine 2% during cataract surgery (P<0.001) at the end of surgery (P<0.002), and up to 30 min after surgery (P<0.001). There were no statistically significant differences between the two groups 5 h after surgery. Epithelial toxicity was similar in both groups, and patient comfort and surgeon assessment of patient cooperation were better in the levobupivacaine group. Conclusions. Topical anaesthesia with levobupivacaine 0.75% was more effective than lidocaine 2% in preventing pain and improving patient and surgeon comfort during cataract surgery, with similar toxicity. © The Board of Management and Trustees of the British Journal of Anaesthesia 2009. All rights reserved.