Comparison of the effect of the intracameral lidocaine anesthesia and subconjunctival lidocaine anesthesia on the development of intraoperative floppy-iris syndrome in cataract surgery

Abstract

Aim: To evaluate the effect of intracameral lidocaine anesthesia (ILA) and subconjunctival lidocaine anesthesia (SLA) administered during cataract surgery on the development and prevalence of intraoperative floppy iris syndrome (IFIS). Material and Method: The study involved the medical records of 86 cataract patients having no risk factors other than small pupil size for IFIS whom ILA and/or SLA were applied during phacoemulsification surgery. While 45 patients were administered intracameral lidocaine anesthesia ILA (1%), 41 patients in the other group were administered subconjunctival lidocaine anesthesia (SLA) (2%). Floppy iris syndrome findings such as iris billowing, iris incarceration in the wound site, or progressive myosis, if any, were recorded. The groups were compared in terms of the prevalence of IFIS development. Results: While IFIS ratio was 33.7% in the ILA group, it was 17.1% in the SLA group (p=0.084). Patients with smaller pupil diameter observed a higher IFIS rate ( when pupil diameter threshold value was 6.5 mm p=0.011 and 6 mm p=0.009). Conclusion: During cataract surgery, surgeons should care for the development of IFIS in patients with small pupil diameters. However, the effect of intracameral lidocaine use on the development of IFIS has not been determined.

Keywords

• Cataract
• phacoemulsification
• iris diseases
• local anesthesia

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