Corneal Endothelial Safety of Intracameral Preservative-free 1% Xylocaine

<b>Purpose</b> : To evaluate the effect of intracameral preservative-free 1&#x0025; xylocaine on the corneal endothelium as an adjuvant to topical anaesthesia during phacoemulsification and Acrysof foldable IOL implantation. <b> Material &#x0026; Methods:</b> This is...

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Bibliographic Details
Main Authors: Shah Alpesh, Diwan Rasesh, Vasavada Abhay, Keng Manzoor
Format: Article
Language:English
Published: Wolters Kluwer Medknow Publications 2004-01-01
Series:Indian Journal of Ophthalmology
Subjects:
Online Access:http://www.ijo.in/article.asp?issn=0301-4738;year=2004;volume=52;issue=2;spage=133;epage=8;aulast=Shah
Description
Summary:<b>Purpose</b> : To evaluate the effect of intracameral preservative-free 1&#x0025; xylocaine on the corneal endothelium as an adjuvant to topical anaesthesia during phacoemulsification and Acrysof foldable IOL implantation. <b> Material &#x0026; Methods:</b> This is a prospective, controlled, randomised, double-masked study. 106 patients with soft to moderately dense (Grade 1-3) senile cataract and corneal endothelial cell density of &gt;1500/mm2 were randomised to the xylocaine group (n=53) and control group(n=53). Central endothelial specular microscopy and ultrasound corneal pachymetry were performed preoperatively. On the first postoperative day the eyes were evaluated for corneal oedema and Descemet&#x2032;s folds. Ultrasound corneal pachymetry was performed at 1, 3 and 12 months. Specular microscopy was performed at 3 and 12 months. Cell loss was expressed as a percentage of preoperative cell density. Six patients could not complete one year follow-up. Chi-square and paired t test (2 tail) statistical tests were applied for analysis. <b> Results: </b> Four (7.54&#x0025;) patients in the xylocaine group and 5 (9.43&#x0025;) in the control group had a few Descemet&#x2032;s folds associated with mild central stromal oedema. Corneal thickness increased from 549.3&#x00B5; &#x00B1; 37.2&#x00B5; to 555.5&#x00B5; &#x00B1; 36.5&#x00B5; in the xylocaine group and from 553.1&#x00B5; &#x00B1; 36.2&#x00B5; to 559.3&#x00B5; &#x00B1; 40.5&#x00B5; in the control group at the one-month postoperative visit. Thickness returned to the preoperative level in xylocaine group 549.6&#x00B5; &#x00B1; 34.5&#x00B5; and control group 554.7&#x00B5; &#x00B1; 41.1&#x00B5; at three months. (P=0.484) The percentage of cell loss was 4.47 &#x00B1; 2.53&#x0025; in the xylocaine group and 4.49 &#x00B1; 3.09 &#x0025; in the control group at one year. (P=0.97) <b> Conclusion:</b> Intracameral preservative-free 1&#x0025; xylocaine does not appear to affect corneal endothelium adversely during phacoemulsification.
ISSN:0301-4738