Ophthalmologic irrigation solutions and method
US-9399040-B2 · Jul 26, 2016 · US
US2016106761A1 · US · A1
| Field | Value |
|---|---|
| Publication number | US-2016106761-A1 |
| Application number | US-201514946435-A |
| Country | US |
| Kind code | A1 |
| Filing date | Nov 19, 2015 |
| Priority date | Jul 30, 2002 |
| Publication date | Apr 21, 2016 |
| Grant date | — |
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Solutions for perioperative intraocular application by continuous irrigation during ophthalmologic procedures are provided. These solutions include multiple agents that act to inhibit inflammation, inhibit pain, effect mydriasis (dilation of the pupil), and/or decrease intraocular pressure, wherein the multiple agents are selected to target multiple molecular targets to achieve multiple differing physiologic functions, and are included in dilute concentrations in a balanced salt solution carrier.
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1 . (canceled) 2 . The method of claim 25 , wherein each of the agents contributes to the maintenance of intraoperative mydriasis by providing for mydriasis or inhibiting miosis. 3 . The method of claim 25 , wherein the NSAID is included in the solution at a concentration of no more than 100,000 nanomolar and the alpha-1 adrenergic receptor agonist is included in the solution at a concentration of no more than 500,000 nanomolar. 4 . The method of claim 25 , wherein the solution further comprises an analgesic agent selected from the group consisting of local anesthetics and opioids. 5 . The method of claim 4 , wherein: the local anesthetic, if selected, is selected from the group consisting of lidocaine, tetracaine, bupivacaine, and proparacaine; and the opioid, if selected, is selected from the group consisting of morphine, fentanyl and hydromorphone. 6 . The method of claim 25 , wherein the NSAID is selected from the group consisting of flurbiprofen, suprofen, diclofenac, ketoprofen, ketorolac, indomethacin, naproxen, and ibuprofen. 7 . The method of claim 25 , wherein the NSAID is selected from the group consisting of flurbiprofen, suprofen, diclofenac, ketoprofen and ketorolac. 8 . The method of claim 25 , wherein the NSAID comprises an acetic acid. 9 . The method of claim 8 , wherein the NSAID is selected from the group consisting of diclofenac, ketorolac, indomethacin. 10 . The method of claim 25 , wherein the alpha-1 adrenergic receptor agonist is selected from the group consisting of phenylephrine and epinephrine. 11 . The method of claim 25 , wherein the solution further comprises an agent for decreasing intraocular pressure (“IOP reducing agent”) selected from the group consisting of beta adrenergic receptor antagonists, carbonic anhydrase inhibitors, alpha-2 adrenergic receptor agonists, and prostaglandin agonists. 12 . The method of claim 11 , wherein: the beta adrenergic receptor antagonist, if selected, is selected from the group consisting of timolol, metipranolol and levobunolol; the carbonic anhydrase inhibitor, if selected, is selected from the group consisting of brinzolamide and dorzolamide; the alpha-2 adrenergic receptor agonist, if selected, is selected from the group consisting of apraclonidine, brimonidine and oxymetazoline; and the prostaglandin agonist, if selected, is selected from the group consisting of latanoprost, travoprost and bimatoprost. 13 . The method of claim 25 , wherein the solution is continuously applied to the intraocular tissues during the intraocular procedure. 14 . The method of claim 25 , wherein the liquid irrigation carrier further comprises an adjuvant selected from electrolytes sufficient to provide a physiological balanced salt solution, a cellular energy source, a buffering agent, a free-radical scavenger and mixtures thereof. 15 . The method of claim 14 , wherein: the electrolytes, if selected, comprise from 50 to 500 millimolar sodium ions, from 0.1 to 50 millimolar potassium ions, from 0.1 to 5 millimolar calcium ions, from 0.1 to 5 millimolar magnesium ions, from 50 to 500 millimolar chloride ions, and from 0.1 to 10 millimolar phosphate; the buffer, if selected, comprises bicarbonate at a concentration of from 10 to 50 millimolar; the cellular energy source if selected, is selected from dextrose and glucose and is present at a concentration of from 1 to 25 millimolar; and the free-radical scavenger, if selected, comprises glutathione at a concentration of from 0.05 to 5 millimolar. 16 . The method of claim 25 , wherein the liquid irrigation carrier further comprises electrolytes sufficient to provide a physiological balanced salt solution, a cellular energy source, a buffering agent and a free-radical scavenger. 17 . The method of claim 16 , wherein: the electrolytes comprise from 50 to 500 millimolar sodium ions, from 0.1 to 50 millimolar potassium ions, from 0.1 to 5 millimolar calcium ions, from 0.1 to 5 millimolar magnesium ions, from 50 to 500 millimolar chloride ions, and from 0.1 to 10 millimolar phosphate; the buffer comprises bicarbonate at a concentration of from 10 to 50 millimolar; the cellular energy source is selected from dextrose and glucose and is present at a concentration of from 1 to 25 millimolar; and the free-radical scavenger comprises glutathione at a concentration of from 0.05 to 5 millimolar. 18 . The method of claim 25 , wherein the pH of the irrigation solution is between 5.5 and 8.0. 19 . The method of claim 25 , wherein the solution comprises the MAID that comprises an aromatic carboxylic acid and phenylephrine. 20 . The method of claim 25 , wherein the solution comprises the NSAID that comprises an aromatic carboxylic acid and epinephrine. 21 . A method for perioperatively inhibiting ocular inflammation and maintaining mydriasis during an intraocular ophthalmologic procedure, comprising irrigating intraocular tissues during an intraocular ophthalmologic procedure with a solution including at least an anti-inflammatory agent and a mydriatic agent in a liquid irrigation carrier, wherein the anti-inflammatory agent comprises a non-steroidal anti-inflammatory drug (NSAID) selected from the group consisting of flurbiprofen, suprofen, diclofenac, ketoprofen, ketorolac, indomethacin, naproxen, and ibuprofen and the mydriatic agent is an alpha-1 adrenergic receptor agonist selected from the group consisting of epinephrine and phenylephrine and each of the agents is included in a therapeutically effective amount for the maintenance of mydriasis during the procedure and the reduction of postoperative pain when delivered intraocularly during the intraocular ophthalmologic procedure. 22 . The method of claim 21 , wherein each of the agents contributes to the maintenance of intraoperative mydriasis by providing for mydriasis or inhibiting miosis. 23 . (canceled) 24 . (canceled) 25 . A method for perioperatively inhibiting ocular inflammation and maintaining mydriasis during an intraocular ophthalmologic procedure, comprising irrigating intraocular tissues during an intraocular ophthalmologic procedure with a solution including at least an anti-inflammatory agent and a mydriatic agent in a liquid irrigation carrier, wherein the anti-inflammatory agent comprises a non-steroidal anti-inflammatory drug (NSAID) and the mydriatic agent comprises an alpha-1 adrenergic receptor agonist that comprises a phenethylamine, and each of the agents is included in a therapeutically effective amount for the maintenance of mydriasis during the procedure and the reduction of postoperative pain when delivered intraocularly during the intraocular ophthalmologic procedure. 26 . A method of irrigation during an intraocular ophthalmologic procedure, comprising irrigating intraocular tissues during an intraocular ophthalmologic procedure with a solution including at least an anti-inflammatory agent and a mydriatic agent in a liquid irrigation carrier, wherein the anti-inflammatory agent comprises a non-steroidal anti-inflammatory drug (NSAID) and the mydriatic agent comprises an alpha-1 adrenergic receptor agonist that comprises a phenethylamine and each of the agents is included in a therapeutically effective amount for the maintenance of mydriasis during the procedure and the reduction of postoperative pain when delivered intraocularly during the intraocular ophthalmologic procedure. 27 . A method of irrigation durin
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Mydriatics or cycloplegics · CPC title
Artificial tears; Irrigation solutions · CPC title
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