Lidocaine gel provides superior analgesia compared to oxybuprocaine drops in pterygium surgery: A double-masked randomized trial.
Caio Henrique Peres Oliani, Nicoli Lopes de Oliveira, Luiz Antônio de Brito Martins et al.
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In 30 seconds
This double-masked randomized trial compared topical 2% lidocaine gel with 0.4% oxybuprocaine drops for anesthesia during pterygium surgery in adults with bilateral primary nasal pterygia. In the final analysis of 133 eyes, mean pain scores were lower with lidocaine gel at both 24 hours (3.95 ± 3.14 vs. 5.09 ± 3.06; p = 0.037) and 30 days (1.55 ± 2.14 vs. 2.69 ± 2.37; p = 0.004). Analgesic use was numerically less frequent with lidocaine, but the difference was not statistically significant. No complications were observed.
Key findings
- At 24 hours, mean VAS pain scores were 3.95 ± 3.14 with lidocaine gel and 5.09 ± 3.06 with oxybuprocaine (p = 0.037).
- At 30 days, mean VAS scores were 1.55 ± 2.14 with lidocaine gel and 2.69 ± 2.37 with oxybuprocaine (p = 0.004).
- First-day oral analgesic use was 7.4% with lidocaine gel versus 17.6% with oxybuprocaine (p = 0.145); no complications were observed.
- Three patients declined second-eye surgery after marked discomfort during their first procedure with oxybuprocaine.
Why it matters
Pain control is an important component of pterygium surgery, and this trial found lower reported pain with lidocaine gel at both early and later postoperative assessments. The findings also highlight that discomfort may affect willingness to undergo a planned second-eye procedure. The analgesic-use difference was not statistically significant, so the pain-score results are the clearest comparative signal.
What to keep in mind
Three patients did not undergo second-eye surgery after discomfort with oxybuprocaine, leaving an unequal number of eyes in the treatment groups. Pain was assessed by patient-reported VAS scores.