Effect of topical application of 2% lidocaine gel on corneal sensitivity of clinically normal equine eyes

Abstract

ObjectiveTo assess the degree and duration of corneal anaesthesia provided by topical application of a non-ophthalmic 2% lidocaine gel in horses. Study designExperimental, ‘blinded’, randomized prospective study. AnimalsTwelve adult horses without relevant ocular abnormalities. MethodsBaseline corneal touch threshold (CTT) measurements were obtained bilaterally by use of a Cochet–Bonnet aesthesiometer just prior to topical treatment. A volume of 0.2mL of 2% lidocaine gel was administered in one randomly selected eye and the same volume of a viscous lubricant in the other eye to serve as control. The CTT value was measured on both eyes 5, 10, 20, 30, 45, 60, 75 and 90 minutes after drug application. The potential for local adverse effects following lidocaine gel application was also evaluated. ResultsMean CTT baseline measurements were not significantly different (p>0.05) between the control eyes (3.41±0.56cm) and those subsequently treated with the lidocaine gel (3.50±0.64cm). In control eyes, no significant changes in corneal sensitivity (p>0.05) occurred over time during the study period. By contrast, a marked reduction in corneal sensitivity was observed after lidocaine application, with mean CTT values significantly lower (p<0.001) than those of the control eyes from 5 to 75 minutes. A steady-state maximal corneal anaesthesia was present from 10 to 45 minutes after lidocaine gel application with mean CTT values ranging from 0.21 to 0.45cm. Corneal epithelial irregularities were detected in three lidocaine-treated eyes, but spontaneous resolution occurred within 24hours. Conclusions and clinical relevanceDeep and sustained corneal anaesthesia is achieved after application of 2% lidocaine gel to the equine eye, with minimal changes in the corneal epithelium. It might be useful for minor ophthalmic surgeries performed in the standing sedated horse.