Lidocaine gel provides superior analgesia compared to oxybuprocaine drops in pterygium surgery: A double-masked randomized trial

PurposeTo compare the analgesic efficacy of 2% lidocaine gel and 0.4% oxybuprocaine eye drops in patients undergoing pterygium surgery, focusing on perioperative pain assessed in the early postoperative period and postoperative discomfort over one month.MethodsSixty-eight adult patients with bilateral primary nasal pterygia underwent two separate surgeries, one in each eye, at least 30 days apart. Each eye was randomly assigned to receive either 2% lidocaine gel or 0.4% oxybuprocaine eye drops for topical anesthesia. Pain perception was evaluated using the Visual Analog Scale (VAS) at 24 h and 30 days after surgery. VAS scores at 24 h reflected early perioperative pain as recalled in the immediate postoperative period, encompassing discomfort related to the surgical experience. Secondary outcomes included oral analgesic use during the first postoperative day and complications.ResultsThree patients declined second-eye surgery after marked discomfort during the first procedure performed with oxybuprocaine. The final sample comprised 133 eyes (68 eyes with oxybuprocaine, 65 with lidocaine gel). Mean VAS scores were significantly lower in the lidocaine group at 24 h (3.95 ± 3.14 vs. 5.09 ± 3.06; <i>p</i> = 0.037) and 30 days (1.55 ± 2.14 vs. 2.69 ± 2.37; <i>p</i> = 0.004). Analgesic intake within 24 h was less frequent with lidocaine gel (7.4% vs. 17.6%; <i>p</i> = 0.145). No complications were observed.ConclusionsTopical 2% lidocaine gel provided superior analgesia compared with 0.4% oxybuprocaine, resulting in lower early perioperative pain assessed postoperatively and reduced postoperative discomfort after pterygium surgery, while maintaining an excellent safety profile.