The effect of Xylocaine Hydrodissection on posterior capsule opacification after cataract surgery

Abstract

BACKGROUND The purpose of this study is to assess the efficacy in reduction in posterior capsule opacification following cataract surgery by the use of Xylocaine brand of lidocaine 1% unpreserved 1 mL as hydrodissection fluid replacing balanced salt solution. METHOD The author performed all surgeries without any change in lens design or operative technique except for the change in hydrodissection fluid. There was no increase in complication rate of surgeries performed with Xylocaine as compared to those with balanced salt. The efficacy of the change in technique was assessed by the change in incidence of neodymiun:yttrium aluminium garnet (Nd:YAG) laser requirement which was separately assessed by an independent ophthalmologist. Minimum follow up exceeds two years with a maximum of eight years. RESULTS Xylocaine hydrodissection in this series did not reduce the already decreasing incidence of posterior capsule opacification at the 2 year review. The ‘p’ value was 0.855 representing no significant difference. The result must be seen against the general improvement worldwide and also by the author in the reduction of posterior capsule opacification to less than 5% over the years by improving operative techniques, lens materials and lens designs. CONCLUSION Hydrodissection with unpreserved Xylocaine 1% mL is safe, and cheap and requires no change in surgical technique. Xylocaine is known to be toxic to some bacterial cells and in a dose dependent relationship with corneal endothelial cells. A further larger double masked prospective trial would cover a shorter time span and eliminate the comparison with an overall trend line. There are very few safe pharmacological methods currently available clinically for PCO reduction and none in common use.