Posters

Is the rate of posterior capsular opacification influenced by the routine use of intracameral lidocaine during phacoemulsification cataract surgery? A retrospective cohort study

Poster Details

First Author: A. Delaney UK

Co Author(s): M. Khan   A. Callear                 

Abstract Details

Purpose:

A number of in vitro studies have suggested that lidocaine reduces the proliferation of lens epithelial cells (LECs). We know that it is the migration and abnormal proliferation of LECs which results in posterior capsular opacification (PCO) following cataract surgery. We conducted this retrospective cohort study to explore whether routine use of intracameral lidocaine during phacoemulsification surgery affects the rate of development of post-operative PCO.

Setting:

The Eye Unit. Royal Shrewsbury Hospital. Shrewsbury. UK.

Methods:

In this retrospective cohort study, we looked at the rate of PCO in patients who previously underwent phacoemulsification cataract surgery with an acryllic IOL at two hospital sites. Preservative-free intracameral lidocaine 1% was routinely employed at one site and no intracameral anaesthesia was used at the second site. A total of 860 patient records were retrospectively reviewed across the two sites between July 2012 and July 2016. The rate of YAG capsulotomy for PCO was compared between the two sites.

Results:

From 860 patients, 503 (58%) received intracameral 1% preservative-free lidocaine whereas 357 (42%) received no intracameral anaesthesia during routine phacoemulsification cataract surgery. 31 patients (8.7%) from the cohort where intracameral lidocaine was omitted subsequently required YAG capsulotomy for PCO whereas 50 patients (9.9%) required YAG capsulotomy from the group where intracameral lidocaine was routinely employed.

Conclusions:

A number of in vitro studies have suggested that lidocaine reduces the proliferation of lens epithelial cells (LECs) and therefore may, theoretically, reduce the rate of postoperative posterior capsular opacification.. Our results indicate that routine use of intracameral lidocaine during phacoemulsification cataract surgery does not affect the rate of post-operative PCO. However, it must be noted that the retrospective nature of the study prevents the establishment of a firm correlation. Prospective, well-designed, randomised controlled trials are required to establish a robust correlation between use of intracameral lidocaine during routine phacoemulsification cataract surgery and the likelihood of developing PCO postoperatively.

Financial Disclosure:

None