Ropivacaine vs tetracaine in topical anesthesia for intravitreal injection

  • Fernanda Pacella
  • Saul Collini
  • Paolo Turchetti
  • Gianpaolo Smaldone
  • Fabiana Troisi
  • Mauro Salducci
  • Elena Pacella
Keywords: ropivacaine vs tetracaine, anesthesia topical, intravitreal injection


Aim: The object of the study was to evaluate the long term efficacy and safety of ropivacaine 0,5% vs tetracaine 0,5% for topical
anesthesia in intravitreal injection of dexamethasone in patients with diabetic macular edema (DME) and anti-vascular endothelial growth factor (VEGF) therapy.
Methods: Thirty-seven patients were enrolled in the study. Intravitreal anti-vascular endothelial growth factor (VEGF) and
Dexamethasone were placed in DME patients.
Intravitreal administration determines appropriate and long-lasting drug's concentration without systemic side effects. Topical
anesthesia under ropivacaine 0,5% vs tetracaine 0,5% was performed.
Results: Intravitreal injection without any supplemental anesthesia and sedation was realized. Patients reported mild pain
(recorded by a 0 to 10 scale) during the procedure with optimal operative result.
Conclusions: Topical anesthesia with ropivacaine and tetracaine is safe and effective in intravitreal injection. The long-lasting
anesthesia secured low pain during this limited but unpleasant procedure.