EP0359766A1 - Fluide vitreux ameliore pour la chirurgie ophtalmique et procede d'utilisation - Google Patents

Fluide vitreux ameliore pour la chirurgie ophtalmique et procede d'utilisation

Info

Publication number
EP0359766A1
EP0359766A1 EP88904341A EP88904341A EP0359766A1 EP 0359766 A1 EP0359766 A1 EP 0359766A1 EP 88904341 A EP88904341 A EP 88904341A EP 88904341 A EP88904341 A EP 88904341A EP 0359766 A1 EP0359766 A1 EP 0359766A1
Authority
EP
European Patent Office
Prior art keywords
approximately
ophthalmic surgery
polyethylene oxide
surgery
viscoelastic
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Withdrawn
Application number
EP88904341A
Other languages
German (de)
English (en)
Other versions
EP0359766A4 (en
Inventor
Phillip E. Pennell
John M. Blackmore
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
MDR Group Inc
Original Assignee
MDR Group Inc
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by MDR Group Inc filed Critical MDR Group Inc
Publication of EP0359766A1 publication Critical patent/EP0359766A1/fr
Publication of EP0359766A4 publication Critical patent/EP0359766A4/en
Withdrawn legal-status Critical Current

Links

Classifications

    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F9/00Methods or devices for treatment of the eyes; Devices for putting in contact-lenses; Devices to correct squinting; Apparatus to guide the blind; Protective devices for the eyes, carried on the body or in the hand
    • A61F9/007Methods or devices for eye surgery
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61KPREPARATIONS FOR MEDICAL, DENTAL OR TOILETRY PURPOSES
    • A61K9/00Medicinal preparations characterised by special physical form
    • A61K9/0012Galenical forms characterised by the site of application
    • A61K9/0048Eye, e.g. artificial tears
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61LMETHODS OR APPARATUS FOR STERILISING MATERIALS OR OBJECTS IN GENERAL; DISINFECTION, STERILISATION OR DEODORISATION OF AIR; CHEMICAL ASPECTS OF BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES; MATERIALS FOR BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES
    • A61L27/00Materials for grafts or prostheses or for coating grafts or prostheses
    • A61L27/14Macromolecular materials
    • A61L27/26Mixtures of macromolecular compounds
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61LMETHODS OR APPARATUS FOR STERILISING MATERIALS OR OBJECTS IN GENERAL; DISINFECTION, STERILISATION OR DEODORISATION OF AIR; CHEMICAL ASPECTS OF BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES; MATERIALS FOR BANDAGES, DRESSINGS, ABSORBENT PADS OR SURGICAL ARTICLES
    • A61L2430/00Materials or treatment for tissue regeneration
    • A61L2430/16Materials or treatment for tissue regeneration for reconstruction of eye parts, e.g. intraocular lens, cornea

Definitions

  • the outer epithelial surface of the cornea must be lubricated continuously with some type of moisturizing agent to keep it from drying out under the heat generated by the operating microscope light.
  • Methylcellulose has a long history of safe and effective use for ophthalmic applications.
  • Dr. Kenneth C. Swan studied the effects of methylcellulose on the ocular tissues of rabbit eyes. He suggested its use as a vehicle for ophthalmic drugs, to treat keratoconjunctiviti ⁇ sicca and as an emollient.
  • Flemming, Merrill and Girard reported on further studies of methylcellulose in relation to irritation, hypersensitivity and its outflow from the anterior chamber of the rabbit eye.
  • methylcellulose as an intraocular lens coating serving to protect the corneal endothelium in rabbits was made by Drs. Kaufman and Katz in 1976. In the following year Dr. Paul Fechner reported upon the first human clinical use of methylcellulose to coat an intraocular lens prior to implantation.
  • Dr. Scott M. MacRae who compared the efficacy and toxicity of sodium hyaluronate, methylcellulose and chrondroitin sulfate, all three of which are used as protective substances suitable for use in ophthalmic surgery.
  • Drs. Smith and Lindstrom evaluated the safety and efficacy of 2% methylcellulose in cat and monkey implant surgery with favorable results.
  • the present invention relates to an improved viscoelastic formulation which when used in dilute form as a topical solution in place of balanced salt solution to keep the corneal surfaces moist lasts up to ten times as long in the eye before having to be renewed.
  • the same unique formulation when used in a different concentration has proven to be equally as good if not better than sodium hyaluronate for use as a protective agent for the inner endothelial corneal surface and other delicate inner eye structures during ophthalmic surgery and considerably less expensive.
  • the invention also encompasses the novel method of using the two different yet compatible solutions together during ophthalmic surgery so as to simultaneously protect the cornea and irrigate it without obscuring the surgeon's view of the site in any way.
  • the Woltersdorf patent also mentions the use of hydroxypropylmethyl cellulose and polyethylene oxide as solid water soluble carriers for the active medicament of the invention, namely, the carbonates of 6 or 5-hydroxy-2- benzothiazolesulfonamide for use in the reduction of elevated intraocular pressure of the type often associated with glaucoma.
  • these high molecular weight substances are used merely as a base for the active ingredient when used as a solid insert as opposed to a solution administered in the form of drops. There is no mention of them being used together nor is their elastic property of any consequence in this application.
  • This invention encompasses a novel fluid viscoelastic formulation of variable viscosity for use in ophthalmic surgery containing as its active ingredients a mixture of both hydroxypropylme h l cellulose and polyethylene oxide together with a physiologic buffered saline solution.
  • Hydroxypropylmethyl cellulose is clear, non-toxic and quite viscous, however, it is also essentially non-elastic.
  • polyethylene oxide which is a thixotropic material having a nominal molecular weight of 4 million, greatly improves the elasticity of the mixture and makes it comparable, if not superior, to sodium hyaluronate for use as a viscoelastic material in ophthalmic surgery.
  • different relative concentrations of the two active ingredients in the aforesaid composition have proven to be far superior to balanced salt solution for topical application to keep the tissues moist during surgery by maintaining a smooth, hydrated cornea under the heat of the operating room microscope light.
  • the two solutions contain the same active ingredients, they are fully compatible and can be used simultaneously to both protect and irrigate the delicate corneal tissues.
  • the principal object of the present invention to provide an improved viscoelastic solution for use in ophthalmic surgery which is made up in two different concentrations and administered simultaneously to both protect and irrigate the corneal tissues.
  • a second object is to provide a solution of the type aforementioned which is susceptible of being made up in selected viscosities by changing the relative concentrations of the active ingredients to adapt it for use as either a topical moisturizing agent or a protective shield for the delicate corneal surfaces and epithelial cells within the inner eye.
  • Another objective of the invention herein disclosed and claimed is that of providing a topical moisturizing agent which remains effective many times longer than the conventional balanced salt solution while, at the same time, doing a better job.
  • Still another objective of the within-described invention is to provide a protective solution for intracorneal use in eye surgery which has excellent clarity and transparency but, more importantly, much improved elasticity when compared with hydroxypropylmethyl cellulose alone.
  • An additional object is to provide a high-molecular weight viscoelastic mixture which is equally effective if not, in fact, superior to sodium hyaluronate-based products at a fraction of the cost.
  • the anterior chamber of the eye is filled with circulating aqueous, whereas its posterior chamber with vitreous.
  • the endothelial cell layer of the cornea is easily damaged and, once lost, these cells do not regenerate.
  • the surgical procedures used in cataract surgery, corneal transplants and other types of ophthalmic surgery are likely to result in damage to these delicate cells unless measures are taken to protect them in the manner in which aqueous does naturally.
  • hyaluronate-based products The main problem with hyaluronate-based products is their cost which at the present time runs around $70 or so for less than a cubic centimeter of material. While attempts have been made to use various methylcellulose derivatives as less expensive viscoelastic substitutes, they have not been well accepted nor do they work as well as hyaluronate.
  • the other problem encountered in ophthalmic surgery is that of keeping the external tissues of the eye moist under the drying effect of the operating microscope. As previously noted, this is generally handled on a more-or-less continuous basis by irrigating the external corneal tissues with a balanced salt solution, sometimes as often as twice a minute.
  • a carefully modified mixture used as the intraocular viscoelastic material for the internal tissues can be advantageously used as a topical solution to keep the external corneal tissues moist many times longer than the balanced salt solution by merely varying the relative concentrations and, therefore, the resulting viscosity of the previously-mentioned intraocular viscoelastic solution that acts as a supplement and substitute for the naturally-occurring vitreous.
  • the topical solution will contain approximately 1% hydroxypropylmethyl cellulose and 20 ppm polyethylene oxide carried in a physiologic saline solution.
  • the intraocular viscoelastic composition will have the concentration of the hydroxypropylmethyl cellulose increased to 2% while the concentration of the polyethylene oxide is reduced to only 10 ppm.
  • a unique method of simultaneously irrigating and protecting the delicate corneal tissues is taught using two fully compatible solutions containing the same active ingredients but in different concentrations. When this is done, the stroirta and entire cornea is hydrated while the fluid loss through the incision is minimized. It also acts as a tamponade on the scleral flap area.
  • a non-toxic and physiologically inert tinting material may be added so that the surgeon can be surer that he or she has removed most of the fluid added during the surgery.
  • the resulting compositions, with or without the dye have proven to be every bit as effective as hyaluronate-based preparations while being far less expensive and, at the same time, lowering operating room costs due to the more efficient use of personnel that results from the less frequent need for irrigation of the corneal tissues.

Landscapes

  • Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Ophthalmology & Optometry (AREA)
  • Veterinary Medicine (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Chemical & Material Sciences (AREA)
  • Medicinal Chemistry (AREA)
  • Epidemiology (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Oral & Maxillofacial Surgery (AREA)
  • Dermatology (AREA)
  • Surgery (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Transplantation (AREA)
  • Vascular Medicine (AREA)
  • Pharmacology & Pharmacy (AREA)
  • Pharmaceuticals Containing Other Organic And Inorganic Compounds (AREA)
  • Materials For Medical Uses (AREA)
  • Prostheses (AREA)
  • Medicinal Preparation (AREA)

Abstract

Succédané vitreux viscoélastique amélioré destiné à être utilisé en chirurgie ophtalmique, consistant en un mélange d'hydroxypropylméthyl-cellulose et d'oxyde de polyéthylène dans des concentrations sélectionnées ne dépassant pas environ 2 % et 200 ppm, respectivement, et contenu dans une solution saline physiologiquement équilibrée. L'invention se rapporte également à un nouveau procédé de protection et de lubrification des tissus cornéens pendant l'intervention chirurgicale, utilisant différentes concentrations de la même solution introduite simultanément pour protéger la cornée interne tout en irriguant périodiquement la cornée externe, et ceci sans entraver le champ de vision du chirurgien.
EP19880904341 1987-05-04 1988-04-27 Improved viscoelastic fluid for ophthalmic surgery and method of using same Withdrawn EP0359766A4 (en)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
US4532687A 1987-05-04 1987-05-04
US45326 1987-05-04

Publications (2)

Publication Number Publication Date
EP0359766A1 true EP0359766A1 (fr) 1990-03-28
EP0359766A4 EP0359766A4 (en) 1990-12-19

Family

ID=21937238

Family Applications (1)

Application Number Title Priority Date Filing Date
EP19880904341 Withdrawn EP0359766A4 (en) 1987-05-04 1988-04-27 Improved viscoelastic fluid for ophthalmic surgery and method of using same

Country Status (6)

Country Link
EP (1) EP0359766A4 (fr)
JP (1) JPS6464653A (fr)
AU (1) AU1726088A (fr)
CA (1) CA1317226C (fr)
GB (1) GB2204238A (fr)
WO (1) WO1988008709A1 (fr)

Families Citing this family (9)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
DE4020623C2 (de) * 1990-06-29 1996-06-05 Mezotraslevoj Nt Kompleks Mikr Hornhaut-Protektor und Verfahren zu dessen Herstellung
CA2161774C (fr) * 1993-04-30 2000-01-04 Nestle S.A. Substance viscoelastique synthetique pour applications ophtalmiques
RU2115413C1 (ru) * 1997-03-03 1998-07-20 Малое государственное предприятие "Научно-экспериментальное производство" Ирригационный раствор "интрасол"
EP1132065A1 (fr) * 2000-03-07 2001-09-12 Gerrit Reinold Jacob Melles Composition visco-élastique colorée
AU2002239601B2 (en) * 2000-12-20 2005-09-01 Alcon Inc. Intraocular irrigating solution having improved flow characteristics
AU2002228955B2 (en) 2000-12-20 2005-09-29 Alcon Inc. Solution for removing cataracts via liquefracture
US7084130B2 (en) 2001-12-11 2006-08-01 Alcon, Inc. Intraocular irrigating solution having improved flow characteristics
TWI544922B (zh) 2011-05-19 2016-08-11 愛爾康研究有限公司 高濃度歐羅派特錠(olopatadine)眼用組成物
CN105749360B (zh) * 2016-03-28 2019-06-18 赛克赛斯生物科技股份有限公司 一种保护角膜的组合物及其制备方法与应用

Family Cites Families (7)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
GB1340517A (en) * 1969-12-01 1973-12-12 Burton Parsons Chemicals Inc Ophthalmic solution
US3856919A (en) * 1970-06-08 1974-12-24 Burton Parsons Chemicals Inc Ophthalmic solution
US3947573A (en) * 1969-12-01 1976-03-30 Burton, Parsons And Company, Inc. Opthalmic solution
NL188266C (nl) * 1975-07-29 1992-05-18 Merck & Co Inc Werkwijze ter bereiding van een oogheelkundig inplantaat.
US4287175A (en) * 1978-06-22 1981-09-01 Merck & Co., Inc. Contact lens wetting agents
US4629623A (en) * 1984-06-11 1986-12-16 Biomatrix, Inc. Hyaluronate-poly (ethylene oxide) compositions and cosmetic formulations thereof
GB2167300B (en) * 1984-11-23 1988-11-23 Fisons Plc Formulations

Also Published As

Publication number Publication date
JPS6464653A (en) 1989-03-10
GB2204238A (en) 1988-11-09
CA1317226C (fr) 1993-05-04
WO1988008709A1 (fr) 1988-11-17
EP0359766A4 (en) 1990-12-19
AU1726088A (en) 1988-12-06
GB8808983D0 (en) 1988-05-18

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