Ophthalmologic Irrigation Solutions and Method
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.
1 . A composition for use in promoting mydriasis during an intraocular ophthalmologic procedure, comprising a local anesthetic agent combined with a mydriatic agent that is an alpha-1 adrenergic receptor agonist in a physiologic carrier solution, wherein the alpha-1 adrenergic receptor agonist is included in the solution at a concentration of no more than 1,000,000 nanomolar and the local anesthetic agent is included in the solution at a concentration of no more than 100,000,000 nanomolar and wherein the agents are included in therapeutically effective amounts for mydriasis during the procedure when delivered intraocularly.
2 . The composition of claim 1 , wherein the local anesthetic agent is selected from the group consisting of lidocaine, tetracaine, bupivacaine, and proparacaine.
3 . The composition of claim 1 , wherein the alpha-1 adrenergic receptor agonist is selected from the group consisting of phenylephrine, epinephrine and oxymetazoline.
4 . The composition of claim 1 , wherein the alpha-1 adrenergic receptor agonist is selected from the group consisting of phenylephrine and epinephrine.
5 . The composition of claim 4 , wherein the local anesthetic agent is selected from the group consisting of lidocaine, tetracaine, bupivacaine, and proparacaine.
6 . The composition of claim 1 , wherein the physiologic carrier solution comprises a liquid irrigation carrier.
7 . The composition of claim 6 , wherein the liquid irrigation carrier comprises a balanced salt solution.
8 . The composition of claim 1 , wherein the solution further comprises a non-steroidal anti-inflammatory drug (NSAID).
9 . The composition of claim 8 , wherein the NSAID is selected from the group consisting of flurbiprofen, suprofen, diclofenac, ketoprofen and ketorolac.
10 . The composition of claim 1 , wherein the alpha-1 adrenergic receptor agonist is included in the solution at a concentration of no more than 500,000 nanomolar and the local anesthetic agent is included in the solution at a concentration of no more than 1,200,000 nanomolar.
11 . A composition for use in promoting mydriasis during an intraocular ophthalmologic procedure, comprising a local anesthetic agent combined with a mydriatic agent that is an alpha-1 adrenergic receptor agonist in a physiologic carrier solution, wherein the local anesthetic agent and the alpha-1 adrenergic receptor agonist are included in therapeutically effective amounts to promote mydriasis during the procedure when delivered intraocularly and at concentrations less than that used for conventional topical or systemic delivery.
12 . The composition of claim 11 , wherein the alpha-1 adrenergic receptor agonist is included in the solution at a concentration of no more than 500,000 nanomolar and the local anesthetic agent is included in the solution at a concentration of no more than 1,200,000 nanomolar.