Compositions and methods for the treatment of presbyopia

1. A method of stabilizing a composition comprising aceclidine comprising storing the composition in a container having a headspace at a temperature from about 2 degrees Celsius to about 8 degrees Celsius.

2. The method of claim 1 , wherein the composition is filled into the container under an inert gas overlay.

3. The method of claim 2 , wherein the headspace is purged with an inert gas.

4. The method of claim 1 , wherein the container comprises a closure and a vessel wherein a portion of the closure and a portion of the vessel are sealed with an anti-leaching material selected from the group consisting of biaxially-oriented polyethylene terephthalate, polytetrafluorethylene and aluminum foil.

5. The method of claim 1 , wherein the container is disposed in a second container that is formed with or lined with an anti-leaching material selected from the group consisting of biaxially-oriented polyethylene terephthalate, polytetrafluorethylene and aluminum foil.

6. The method of claim 1 , wherein aceclidine is at a concentration from about 0.25% to about 4.0% w/v aceclidine, wherein w/v denotes weight by total volume of the composition.

7. The method of claim 1 , wherein the method provides at least 90% stability of aceclidine for at least 7 months.

8. The method of claim 5 , wherein the method provides at least 90% stability of aceclidine for at least 12 months.

9. The method of claim 1 , wherein the composition further comprises a viscosity agent, a polysorbate, a cryoprotectant and a preservative.

10. The method of claim 9 , wherein the method provides at least 90% stability of aceclidine for at least 18 months.

11. The method of claim 9 , wherein the viscosity agent provides a viscosity of at least 50 centipoise.

12. The method of claim 9 , wherein the cryoprotectant is selected from the group consisting of a a polyol, a sugar, an alcohol, a lower alkanol, a lipophilic solvent, a hydrophilic solvent, a bulking agent, a solubilizer, a surfactant, an antioxidant, a cyclodextrin, a maltodextrin, colloidal silicon dioxide, polyvinyl alcohol, 2-methyl-2,4-pentanediol, cellobiose, gelatin, polyethylene glycol (PEG), dimethyl sulfoxide (DMSO), formamide, antifreeze protein 752 or a combination thereof.

13. The method of claim 9 , wherein the preservative is selected from the group consisting of benzalkonium chloride, sorbate, an antioxidant and a combination thereof.

14. The method of claim 11 , wherein the antioxidant is selected from the group consisting of sodium ascorbate, sodium bisulfate, soidum metabisulfite, n-acetyl cysteine and a combination thereof.

15. A method of stabilizing a composition comprising aceclidine, a viscosity agent, and a nonionic surfactant comprising storing the composition in a container having a headspace at a temperature from about 2 degrees Celsius to about 8 degrees Celsius, wherein the composition is filled into the container under a nitrogen overlay and the headspace is purged with nitrogen and wherein the composition provides a low shear (1/sec) viscosity from about 50 to about 1000 centipoise and a high shear (1:1000/sec) of about 0.5 or less centipoise.

16. A method of stabilizing a composition comprising aceclidine, hydroxypropylmethyl cellulose, polysorbate 80, mannitol, sorbate and an antioxidant selected from the group consisting of sodium ascorbate, sodium bisulfate, soidum metabisulfite, n-acetyl cysteine or a combination thereof comprising storing the composition in a container having a headspace at a temperature from about 2 degrees Celsius to about 8 degrees Celsius, wherein the composition is filled into the container under a nitrogen overlay and the headspace is purged with nitrogen.

17. The method of claim 16 , wherein the aceclidine is at a concentration from about 0.25% to about 4.00% w/v, the hydroxypropylmethyl cellulose is at a concentration from about 0.75% to about 1.25% w/v, polysorbate 80 is at a concentration from about 2% to about 4% w/v, mannitol is at a concentration from about 2% to about 4% w/v, sorbate is at a concentration from about 0.10% to about 0.12% w/v and the antioxidant is at a concentration from about 0.10% to about 0.25% w/v, wherein w/v denotes weight by total volume of the composition.

18. The method of claim 17 , wherein the method provides at least 90% stability of aceclidine for at least 20 months.

19. The method of claim 18 , wherein the method provides at least 90% stability of aceclidine for at least 22 months.

20. A container comprising aceclidine prepared by the process comprising the steps of:

a) providing a container;

b) filling the container with a composition comprising aceclidine under an inert gas overlay;

c) purging a headspace created during the filling step b) with an inert gas;

d) capping the container.

21. The container of claim 20 , wherein the process further comprises the step of storing the container at a temperature from about 2 to about 8 degrees Celsius.

22. The container of claim 20 , wherein the composition further comprises a preservative selected from the group consisting of sorbate, benzalkonim chloride, sodium ascorbate, sodium bisulfate, soidum metabisulfite, n-acetyl cysteine and a combination thereof.

23. The container of claim 20 , wherein the composition has a viscosity of at least 50 centipoise.

24. A composition comprising from about 0.25% to about 4.0% w/v aceclidine and one or more means of stabilizing the composition selected from the group consisting of filling the composition into a container under an inert gasoverlay and purging a headspace created during filling with an inert gas, having a total viscosity of the composition of at least 50 centipoise or more, adding a preservative to the composition selected from the group consisting of sorbate, benzalkonim chloride, sodium ascorbate, sodium bisulfate, soidum metabisulfite, n-acetyl cysteine and a combination thereof,

wherein the composition is stored at a temperature from about 2 to about 8 degrees Celsius and

wherein w/v denotes weight by total volume of the composition.

25. A method of stabilizing a composition comprising aceclidine comprising storing the composition in a container having a headspace at a temperature from about 22 degrees Celsius to about 25 degrees Celsius, wherein the container comprises a closure and a vessel wherein a portion of the closure and a portion of the vessel are sealed with an anti-leaching material selected from the group consisting of biaxially-oriented polyethylene terephthalate, polytetrafluorethylene and aluminum foil and/or the container is disposed in a second container that is formed with or lined with biaxially-oriented polyethylene terephthalate, polytetrafluorethylene and aluminum foil.

26. The method of claim 25 , wherein the second container comprises a second closure, wherein the second closure provides an airtight seal.

27. The method of claim 26 , wherein the airtight seal is resealable.