| ObjectivePosterior capsule opacification (PCO) is a common complication after extracapsular cataract extraction with or without intraocular lens implantation. Migration and proliferation is the central link of its occurrence and cellular basis. Ever since a long time ago, oculists looked for some effective medicine to eliminate or inhibit lens epithelial cells (LECs) and prevent developing into posterior capsular opacification continuously. This study investigate the effect of preservative-free 1% lidocaine on prevention of posterior capsule opacification (PCO) and provide scientific basis to search safe and effective drugs that can eliminate LECs in cataract surgery.Methods72 patients (60 eyes) with age-related cataract (ARC) were collected in March 2009 to October 2009. They were treated at the second affiliated hospital of Zheng Zhou University and divided into control group (A, with balanced salt solution) and experiment group (B, with preservative-free 1% lidocaine). The age range was 42-85 years. The mean age was 68.98 years. Preservative-free 1% lidocaine was injected into capsular bags by hydrodissetion with phacoemulsification in patient eyes of group B. On the 1st,3rd,7th,14thday and 1st,3rd,6thmonth after operation, the changes of the incision, cornea and anterior chamber were observed by slit-lamp microscope. On the 1st,3rd,6th month after operation, the changes of the posterior capsule opacification were observed and graded by slit-lamp microscope. The different conditions were compared between control group and experiment group.Result1. The corneal conditions of post operationThree days after operation, almost all mild corneal edema occurd around the cuts. But these complications recovered in one week after operation. Compared with the cases of corneal edema on three days after operation between the two groups, there was not significant difference between the two groups (χ2=0.215, P>0.05. Compared with the level of corneal edema on seven days after the operation between the two groups, the difference was not statistically significant between the two groups (Z=-0.486, P>0.05).2. The anterior chamber conditions of post operationA part of operated eyes developed anterior chamber reactions on the 1st and 3rd day after operation. Compared with the cases of aqueous flare between the two groups, there was not significant difference between the the two groups(χ2=0.400,P>0.05). On the 7th day of post operation, only one case of anterior chamber reaction occurs in control group. Compared with the turbidity level of aqueous humour between the two groups, there was not significant difference between the two groups (Z=-1.000, P> 0.05).3. The intraocular pressure conditions of post operationCompared with intraocular pressure between group A and group B on the one day before surgery, the difference was not statistically significant (t=0.120, P>0.05). Compared with intraocular pressure between group A and group B on the one day after surgery, the difference was not statistically significant (t=0.812,P>0.05). Compared with intraocular pressure between group A and group B on the three days after surgery, the difference was not statistically significant (t=-0.981,P>0.05). Compared with intraocular pressure in group A on the one day before surgery and one day after surgery, the result were significantly (t=-20.018, P<0.05). Compared with intraocular pressure in group A on the one day before surgery and three days after surgery, the difference was not statistically significant (t=0.117, P>0.05). Compared with intraocular pressure in group A on the one day after surgery and three days after surgery, the difference was statistically significant (t=20.273, P<0.05). Compared with intraocular pressure in the group B on the one day before surgery and one day after surgery, the difference was statistically significant (t=-20.673, P<0.05). Compared with intraocular pressure in the group B on the one day before surgery and three days after surgery, the difference was not statistically significance (t=0.887, P> 0.05). Compared with intraocular pressure in the group B on the one day after surgery and three days after surgery, the difference was statistically significant (t=19.900, P< 0.05).4. Postoperative best corrected distance visual acuityCompared with best corrected distance visual acuity between group A and group B at one month after surgery, the difference was not statistically significant (t=-0.645, P >0.05). Compared with best corrected distance visual acuity between group A and group B at six months after surgery, the difference was statistically significant (t=-2.763,P<0.05).5. The corneal endothelial conditions of postoperation.Compared with corneal endothelial density between group A and group B on the one day before surgery, the difference was not statistically significant (t=-1.163, P> 0.05). Compared with corneal endothelial density between group A and group B on the three days after surgery, the difference was not statistically significant (t=1.326, P >0.05).6. The posterior capsule opacification conditions of postoperationTwo eyes in group A developed posterior capsular opacification at the one month after surgery. At the same time, one eye in group B developed posterior capsular opacification. Between the two groups, the difference was not statistically significant (χ2=0.348, P>0.05).Five eyes in group A developed posterior capsular opacification at the three months after surgery. At the same time, two eyes in group B developed posterior capsular opacification. Between the two groups, the difference was not statistically significant (χ2=1.424, P>0.05). Eighteen eyes in group A developed posterior capsular opacification at six months after surgery. At the same time, three eyes in group B developed posterior capsular opacification. Between the two groups, the difference was statistically significant (χ2=15.126, P<0.05). Compared with the scores of posterior capsule opacification between group A and group B at the one month after surgery, the difference was not statistically significant (Z=-0.602, P> 0.05). Compared with the scores of posterior capsule opacification between group A and group B at the three months after surgery, the difference was not statistically significant (Z=-1.151, P>0.05). Compared with the scores of posterior capsule opacification between group A and group B at the six months after surgery, the difference was not statistically significant (Z=-3.885, P<0.05).ConclusionThe results suggest that preservative-free 1% lidocaine injected into capsular bags by hydrodissetion during phacoemulsification can destroy LECs without damage to the intraocular organization. The application of preservative-free 1% lidocaine by hydrodissetion can reduce PCO formation safely and effectively.
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