Lidocaine Gel Anesthesia for Intravitreal Drug Administration

In Brief Purpose: To describe the use of topical gel anesthesia for intravitreal injection drug delivery. Methods: The first group (n = 12) of patients is a crossover group of patients who on separate occasions received intravitreal injections after both 2% lidocaine subconjunctival injection (SC) and 2% lidocaine topical gel anesthesia using 30-gauge needle. The second group (n = 16) is a consecutive group of patients who received either SC (n = 8) or gel (n = 8) anesthesia before intravitreal injection of triamcinolone using 27.5-gauge needle. Descriptive and numerical pain analog scale was used to assess pain sensation. Results: There was no difference in pain score between gel and SC within the first group (P = 0.67, paired, nonparametric test) and no difference in pain score comparing patients who had either SC or gel anesthesia before 27.5-gauge intravitreal injections (P = 0.82, unpaired t-test) in the second group. However, there were significant differences in incidence of chemosis (P < 0.001) and subconjunctival hemorrhage (P < 0.001) after injection versus gel anesthesia in both groups. Conclusion: Anesthesia with lidocaine 2% gel provides satisfactory patient comfort for administration of intravitreal injection and causes less chemosis and hemorrhage than SC anesthesia. The authors describe the use of topical gel anesthesia for intravitreal injection drug delivery. Anesthesia with lidocaine 2% gel provides satisfactory patient comfort for administration of intravitreal injection and causes less chemosis and hemorrhage than SC anesthesia.