PurposeTo evaluate pupil dilation from intracameral injection of nonpreserved 1% lidocaine. DesignObservational case series of 25 consecutive phakic trabeculectomies. MethodPatients were evaluated in the operating room setting and given one drop of topical tetracaine preoperatively. Nonpreserved 1% lidocaine (0.1 cc) was injected intracameraly into the anterior chamber through a paracentesis site at the corneal limbus. Pupil diameter was measured after instillation of topical tetracaine, before injection of intracameral lidocaine. Postinjection measurements were made at 1, 3, and 5 minutes. ResultsThe mean male pupil diameter was significantly greater than female dilation at every time point. The mean blue iris diameter was greater than brown at 1 and 3 minutes, but there was no difference at 5 minutes or more. There was no racial difference in the pupil dilation response to intracameral lidocaine. ConclusionsNonpreserved intracameral 1% lidocaine produces immediate pupil dilation in previously undilated phakic patients during trabeculectomy surgery.