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Abstract #20052 Published in IGR 9-4
Efficacy and safety of intravenous injection of lidocaine in the treatment of acute primary angle-closure glaucoma: a pilot study
Jin X; Xue A; Zhao Y; Qin Q; Dong XD; Qu JGraefe's Archive for Clinical and Experimental Ophthalmology 2007; 245: 1611-1616
AIMS: To study the safety and effectiveness of a combination of both intravenous injection of lidocaine and intraocular pressure-lowering medications, in the intraocular pressure control and relief of symptoms of refractory acute primary angle-closure glaucoma (PACG). METHODS: Five consecutive patients with their first attack of acute PACG, with intraocular pressure ≥ 45 mmHg and a failure to release from the attack under antiglaucomatous medications for four hours, were recruited into the study. On presentation, each patient received topical pilocarpine and timolol, and systemic acetazolamide and mannitol as primary treatment. Then the patients were given 2% lidocaine by intravenous injection at dose of 0.8 mg/kg in concert with antiglaucomatous medications. The intraocular pressure was documented by applanation tonometry after intravenous injection at 30 min, and then at 1, 2, 4, 12, and 24 hrs. Symptoms, visual acuity, intraocular pressure, corneal edema, angle status on gonioscopy, pupillary size, and reaction were also measured. RESULTS: Six eyes of five patients seen with acute PACG were recruited. The mean intraocular pressure reduced from 50.83 ± 5.34 mmHg to 39.5 ± 3.45 mmHg at 30 minutes after intravenous injection, and then to 33.3 ± 3.56 mmHg at 1 hour, and 24.55 ± 5.09 mmHg at 2 hours after intravenous injection. The mean intraocular pressure was less than 21 mmHg at 4 hours and beyond. There was instant symptomatic relief for all patients. No complications were encountered. CONCLUSIONS: From this preliminary study, intravenous injection of lidocaine seems to be safe and effective in controlling intraocular pressure and eliminating symptoms in acute PACG. But the exact efficacy and safety need further investigation in large case studies.
Dr. X. Jin, School of Ophthalmology and Optometry, Eye Hospital, Wenzhou Medical College, Wenzhou, Zhejiang 325003, People's Republic of China
Classification:
9.3.1 Acute primary angle closure glaucoma (pupillary block) (Part of: 9 Clinical forms of glaucomas > 9.3 Primary angle closure glaucomas)
11.15 Other drugs in relation to glaucoma (Part of: 11 Medical treatment)