The effect of intracameral anesthesia on macular thickness and ganglion cell-inner plexiform layer thickness after uneventful phacoemulsification surgery: prospective and randomized controlled trial

Abstract

To evaluate the effect of intracameral lidocaine anesthesia on macular thickness and macular ganglion cell-inner plexiform layer (GC-IPL) thickness following uneventful phacoemusification in healthy subjects. This is a prospective, randomized and double- masked study. One hundred eyes of 74 consecutive patients were randomized to receive intracameral preservative-free lidocaine 1% (intracameral lidocaine group) or intracameral injection of balanced salt solution (sham injection group) at the time of the phacoemulsification surgery. Preoperative and postoperative macular thickness analyses with spectral domain optical coherence tomography (SD-ODT) were performed and the results between the two groups were compared. Postoperatively, both the central foveal thickness (CFT) and the thickness of perifoveal macula were significantly improved in both groups (p < 0.001). There was no statistically significant difference between CFT and the inner and outer macular zone thicknesses of the two groups at any follow-up time. In both groups, GC-IPL thickness was significantly increased at the first week and first month visits (p < 0.001). There was no statistically significant difference between GC-IPL thickness measurements of the two groups at any follow-up time. The current study demonstrated that supplementary intracameral lidocaine 1% did not cause more macular thickening than the intracameral sham injection during a follow-up period of 3months. The present study also showed a tendency for a transient increase in high definition SD-OCT-based GC-IPL thickness measurements within a few months following cataract surgery under both intracameral lidocaine anesthesia and intracameral sham injection.