Pain Following the Use of Anesthesia Formulation Among Individuals Undergoing Cataract Surgery: A Randomized Controlled Trial

Abstract

To assess the pain intensity of two intracameral anesthetic solutions in patients undergoing cataract surgery and evaluate the factors influencing the patients' postoperative activities. Methods: Sixty-two patients undergoing cataract surgery were randomized to receive the study druga manufactured solution of 0.02% tropicamide/0.31% phenylephrine/1% lidocaine (Mydrane) or a traditional anesthetic formulation-solution of 1% lidocaine/ 0.025% adrenaline as an intraocular anesthetic. The pain intensity was assessed by Visual Analog Scale for Pain (VAS Pain) and Brief Pain Inventory-short form (BPI) on the next day after the surgery. Results: The mean pain score measured preoperatively with VAS Pain was 0.34 in Mydrane group and 0.09 in the reference group (p = 0.51). There were no statistically significant differences between the two anesthetic methods with respect to pain intensity during the surgery (p = 0.94) and the influence of pain during the last 24 h on activity (p = 0.79), mood (p = 0.31), social contacts (p = 0.29), sleep (p = 0.5) and the joy of life (p = 0.39). Additionally, there was no statistically significant influence of age, sex, lateralization, co-existing ophthalmological diseases (p = 0.98) and post-operative complications (p = 0.4) on the experienced pain measured during the surgery and in the last 24 h. Conclusions: New commercially available intraocular anesthetic solution (Mydrane™) seems to be as effective as off-label traditional anesthetic formulation, in reducing the pain experienced during cataract surgery under topical anesthesia.

Ocular Involvement of SARS-CoV-2 in a Polish Cohort of COVID-19-Positive Patients

“…Any declared symptom was quantitatively assessed 15 min before the ocular swab by an ophthalmologist. A unidimensional visual analog score (VAS) questionnaire 10 cm in length (equivalent to 10 degrees) was used [ 23 ]. Before the measurement, the examiner explained to the patient that the 0 points represented no symptom and that the 10 points represented the most intense symptom that he or she felt at that moment.…”

Dynamic monocyte chemoattractant protein-1 level as predictors of perceived pain during first and second phacoemulsification eye surgeries in patients with bilateral cataract

“…However, some complications of these methods may also be observed. Nowadays, different local anesthesia (topical and intracameral) is the more commonly used [ 5 – 7 ]. Phacoemulsification with IOL under topical anesthesia is widely performed to treat cataract, as it has several advantages such as avoidance of postoperative ptosis or diplopia, immediate visual recovery, decreased patients’ anxiety, shorter operative time, improved intraoperative patient cooperation, and better safety [ 8 , 9 ].…”

Efficacy of the intracamerally administered mydriatics for cataract surgery in patients with primary open-angle glaucoma

“…Toro et al 35 did not find any significant differences between ICM or the traditional combination of 1% lidocaine with 0.025% adrenaline regarding the intensity of pain referred during the surgery. Mydrane® increased the stability of mydriasis due to the action of lidocaine, which impedes membrane depolarization of the motor neurons, innervating the muscles of the iris stroma when used at this dosage (1%).…”

“…Despite no significant differences in pain between patients undergoing ICM and the traditional combination of 1% lidocaine with 0.025% adrenaline, the former experienced less pain than those who underwent either Mydriasert® or eye drops during the surgical procedure ( p = .03). 35 This finding might be related to the cataract surgery-induced dry eye that commonly affects patients undergoing cataract surgery due to both aggravation of preexisting dry eye and toxic effects of preservatives such as benzalkonium chloride to the ocular surface, which is considered a potential risk factor for post-cataract surgery dry eye disease. 36 Moreover, lidocaine contained in Mydrane® effectively improved intraoperative anesthesia, with lower patient discomfort during the entire procedure compared to the standard topical regimen.…”