Ophthalmologic irrigation solutions and method

Abstract

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.

The embodiments of the invention in which an exclusive property or privilege is claimed are defined as follows: 
     
         1 . A composition for use in perioperatively inhibiting ocular inflammation and maintaining mydriasis during an intraocular ophthalmologic procedure, comprising an anti-inflammatory agent and a mydriatic agent in a physiologic irrigation solution for intraocular delivery, wherein the anti-inflammatory agent comprises a non-steroidal anti-inflammatory drug (NSAID) and the mydriatic agent comprises an alpha-1 adrenergic receptor agonist, wherein the NSAID and the alpha-1 adrenergic receptor agonist are included at concentrations less than that used for conventional topical or systemic delivery and 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. 
     
     
         2 . The composition of  claim 1 , wherein the NSAID is selected from the group consisting of flurbiprofen, suprofen, diclofenac, ketoprofen, ketorolac, indomethacin, naproxen, ibuprofen. 
     
     
         3 . The composition of  claim 1 , wherein the NSAID is selected from the group consisting of flurbiprofen, suprofen, diclofenac, ketoprofen and ketorolac. 
     
     
         4 . The composition of  claim 2 , wherein the alpha-1 adrenergic receptor agonist is selected from the group consisting of phenylephrine, epinephrine, and oxymetazoline. 
     
     
         5 . The composition of  claim 1 , wherein the alpha-1 adrenergic receptor agonist is selected from the group consisting of phenylephrine, epinephrine, and oxymetazoline. 
     
     
         6 . The composition of  claim 1 , wherein the alpha-1 adrenergic receptor agonist is selected from the group consisting of phenylephrine and epinephrine. 
     
     
         7 . The composition of  claim 1 , 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. 
     
     
         8 . The composition of  claim 1 , wherein the physiologic solution comprises a balanced salt solution liquid irrigation. 
     
     
         9 . The composition of  claim 8 , wherein the balanced salt solution liquid irrigation carrier further comprises an adjuvant selected from a cellular energy source, a buffering agent, a free-radical scavenger and mixtures thereof. 
     
     
         10 . The composition of  claim 1 , wherein the solution further comprises an analgesic agent selected from the group consisting of local anesthetics and opioids. 
     
     
         11 . The composition of  claim 10 , 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. 
     
     
         12 . A composition for use in perioperatively inhibiting ocular inflammation and maintaining mydriasis during an intraocular ophthalmologic procedure, comprising an anti-inflammatory agent and a mydriatic agent in a physiologic irrigation solution for intraocular delivery, wherein the anti-inflammatory agent comprises a non-steroidal anti-inflammatory drug (NSAID) and the mydriatic agent comprises an alpha-1 adrenergic receptor agonist, wherein the NSAID and the alpha-1 adrenergic receptor agonist are included at concentrations less than that used for conventional topical or systemic delivery and in a therapeutically effective amount for the maintenance of pupil dilation and inhibition of miosis during the procedure and the reduction of postoperative pain when delivered intraocularly during the intraocular ophthalmologic procedure.