Induced endothelial cell loss in phacoemulsification using topical anesthesia plus intracameral lidocaine

Purpose: To determine whether lidocaine 1% injected into the anterior chamber during phacoemulsification damaged the corneal endothelium. Setting: Ophthalmology Service, University Hospital, San Juan de Alicante, Spain. Methods: In 19 eyes of 19 patients, small incision phacoemulsification and foldable lens (AcrySof(R) MA60BM) implantation was performed using topical anesthesia supplemented by lidocaine 1% (0.3 mL) in the anterior chamber. All cases were operated by the same surgeon. Specular microscopy was performed before surgery and 1 and 3 months postoperatively. Results: Mean endothelial cell loss was 5.41% +/- 8.50 (SD) at 1 month and 5.93 +/- 8.50% at 3 months. Conclusions: The endothelial damage was similar to that described by other authors, suggesting that phacoemulsification surgery can be performed successfully using topical anesthesia supplemented by lidocaine 1% in the anterior chamber. J Cataract Refract Surg 1999; 25:640-642 (C) 1999 ASCRS and ESCRS.