From the Research
Ropivacaine (ROPLAS) is not recommended as an alternative to lacrimal syringing before eye surgery. Lacrimal syringing is a diagnostic and therapeutic procedure that uses saline solution to assess and clear blockages in the tear drainage system, while ropivacaine is a local anesthetic typically used for nerve blocks and pain management. These serve fundamentally different purposes in ophthalmic care. For pre-surgical lacrimal assessment, conventional lacrimal syringing with sterile saline remains the standard approach, as seen in studies such as 1, which focused on pain management during lacrimal lavage but did not suggest alternatives to the saline solution for the procedure itself. If anesthesia is needed during lacrimal syringing, topical anesthetics like proparacaine or tetracaine drops are typically applied to the eye surface rather than using ropivacaine, as they are safer and more effective for this purpose, with studies like 1 indicating that even lidocaine may not be effective in reducing pain during lacrimal lavage, suggesting that the procedure's discomfort is more related to the pressure of the fluid than to the need for local anesthesia. Ropivacaine could potentially cause tissue toxicity if injected into the lacrimal system and lacks FDA approval for this specific use. Surgeons should continue using standard lacrimal irrigation techniques with appropriate sterile solutions designed for this purpose to ensure proper assessment of tear duct patency before eye surgery and avoid potential complications from using medications in unapproved ways. The focus should remain on established methods for lacrimal syringing, as supported by the most recent and highest quality studies available, such as 2, which discusses the importance of proper technique and understanding of the lacrimal drainage system for effective syringing, without mentioning the use of ropivacaine or similar alternatives.