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Long-term corneal endothelial changes caused by intracameral xylocaine used in phacoemulsification surgery

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Session Details

Session Title: Corneal Endothelium & Cataract Surgery

Session Date/Time: Monday 24/09/2018 | 16:30-18:00

Paper Time: 17:21

Venue: Room A3, Podium 1

First Author: : C.A. Ganapathi INDIA

Co Author(s): :    K. Kudlu   H. Shetty   S. Shetty              

Abstract Details


To compare endothelial cell loss and the morphological changes, in patients undergoing topical phacoemulsification surgery with intracameral Xylocaine and in ‘Age’ and ‘Cataract density’ matched controls.


Prasad Netralaya Super Specialty Eye Hospital, Udupi, India


This is a prospective, controlled, randomised, double-masked study. 220 patients with immature senile cataract were randomised to the xylocaine group (n=110) and control group (n=110) who did not receive intracameral xylocaine. Central endothelial specular microscopy and corneal pachymetry using IOL master were performed preoperatively. Corneal pachymetry and specular microscopy was performed at 1month and 6 months and 2 year. Cell loss was expressed as a percentage of preoperative cell density. Morphological changes were also studied. Chi-square and paired t test (2 tail) statistical tests were applied for analysis


Corneal thickness increased from 549.3µ ± 37.2µ to 584.5µ ± 36.5µ in the xylocaine group and from 553.1µ ± 36.2µ to 559.3µ ± 40.5µ in the control group at the one-month postoperative visit. Thickness remained higher in xylocaine group 580.6µ ± 34.5µ and control group returned to preoperative level 554.7µ ± 41.1µ at three months. (P=0.184) The percentage of cell loss was 5.47 ± 2.53% in the xylocaine group and 4.49 ± 3.09 % in the control group at two year. (P=0.57). Increased polymegathism and polymorphism was noted in the xylocaine group


Use of intracameral xylocaine in phacoemulsification surgery has a detrimental effect on the corneal endothelial cells. The change noted is not clinically significant. Although, as the pain evaluation scale had no difference between two groups, use of xylocaine can be limited to reduce the ill effects on the endothelial cells which play a major role in the health of the cornea

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