K 86Endothelial toxicity of different topical anesthetics
I. Wübbolt, F. Sistani, D. Brockmann, R. Winter
Introduction: The intracameral injection of topical anesthetics is a possible method of anesthesia for cataract surgery. The endothelial toxicity of these substances in swine corneae was examined in vitro.
Methods: Swine corneae were stored in a medium containing dextran and 10% fetal calf serum (FCS) with the method of organ culture. The endothelial cell count was assesed after one day of incubation. Then the corneae were incubated for one hour in three different concentrations of Lidocain, Prilocain, Mepivacain and Bupivacain. Afterwards the cells were counted and the corneae were stored again. During organ culture the cell count was assessed on 3rd and 5th day of subsequent culturing. A control group without incubation in anesthetics was treated in the same manner.
Results: Different concentrations of Lidocain (0.5%, 1%, 2%) and Mepivacain (1%, 2%, 3%) led to no statistically significant differences in cell density. Among different concentrations of Prilocain just the 2% solution seemed to cause a cell damage. The 0.25% and 0.75% concentration of Bupivacain caused a significant cell reduction compared to the control.
Discussion: A significant cell reduction could be demonstrated after the use of Bupivacain (0.25%, 0.75%) and Prilocain 2%. The intracameral application of Lidocain (0.5%, 1%, 2%) ,Mepivacain (1%, 2%, 3%) and Prilocain (0.5%, 1%) seemed to be safe. Thus, these anesthetics could be siutable for intracameral use.
Dept. of Ophthalmology, Hannover Medical School, Carl Neuberg Str. 1, D-30625 Hannover, Germany