RU2121324C1 - Irrigation solution for ophthalmology - Google Patents

Abstract

FIELD: medicine, ophthalmology. SUBSTANCE: solution containing sodium chloride, sodium dihydrogen phosphate, sodium hydrogen phosphate and water has additionally glycoseaminoglycans, L-carnosine and cytochrome c at the following ratio of components, wt.-%: sodium chloride 0.8-1.0; sodium hydrogen phosphate 0.01-0.09; sodium dihydrogen phosphate 0.001-0.01; glycoseaminoglycans 0.002-0.01; L-carnosine 0.002-0.02; cytochrome c 0.001-0.03, and water - the rest. Solution shows protective and curative properties and can be used in surgery operations in ophthalmology. Solution exhibits an improved equilibrium of components as compared with the known ones. EFFECT: improved quality and properties of solution. 1 cl, 3 ex

Description

 The invention relates to medicine, and more particularly to ophthalmology, and can be used for abdominal and non-abdominal surgery in ophthalmology.

 A known solution for irrigation containing buffer salts, such as phosphates, bicarbonates and chlorides of alkali metals in certain proportions, which is used for intraocular interventions on the organ of vision (Promotional brochure company "Alkon" N 035S93).

 However, clinical data obtained at MNTK "MG" indicate that this solution is inert, can lead to damage to the endothelium and surrounding tissues of the anterior chamber of the eye ("baldness" of the iris) and does not have a therapeutic effect on the tissues of the anterior segment of the eye.

 The objective of the invention is to obtain a balanced saline solution for irrigation, which has protective and therapeutic properties.

The technical result is achieved in that the solution, including sodium chloride, monosubstituted sodium phosphate, disubstituted sodium phosphate and water, additionally contains glycosaminoglycans, L-carnosine, cytochrome C in the following ratio, wt.%:
Sodium Chloride - 0.8 - 1.0
Disubstituted sodium phosphate - 0.01 - 0.09
Monosubstituted sodium phosphate - 0.001 - 0.01
Glycosaminoglycans - 0.002 - 0.01
L-carnosine - 0.002 - 0.2
Cytochrome C - 0.001 - 0.03
Water - Else
At the same time, keratan sulfate, chondroitin sulfate, heparan sulfate, heparin are used as glycosaminoglycans (GAG), which are the main components of connective tissue and have the ability to reduce swelling of the tissues of the anterior chamber of the eye, have a moderate anti-inflammatory effect, as well as the ability to reduce the permeability of hematophthalmic the barrier.

 GAGs are introduced into the solution at a concentration of from 0.002 μg / ml to 0.01 μg / ml, which are obtained by treating the corneas of farm animals (VFS 42-2678-96). A concentration of GAG less than 0.002 μg / ml does not have a pronounced decongestant effect, and a concentration of GAG above 0.01 μg / ml increases the viscosity of the solution, which makes it difficult to irrigate.

 L-carnosine has a pronounced stabilizing effect on the membranes of endothelial cells, a moderate hypotonic effect, due to the muscle relaxant effect on the walls of the Helmet canal. Experimental studies have shown that the minimum concentration of L-carnosine that has the described effect is the concentration of 0.002 μg / ml, and its maximum concentration in solution is 0.2 μg / ml, since an increase in the concentration can lead to undesirable side effects, namely: hyperemia and edema. L-carnosine is obtained by treating the muscle tissue of cattle, and a fraction of hydrochloric acid carnosine, β-alanine histidine, is released (Doctors N 11-12 1940 P. P. Normark et al. Pp. 741-742).

 Cytochrome C is an antihypoxic agent and reduces the level of free radicals that accumulate in large quantities in the anterior chamber of the eye during various surgical interventions. Cytochrome C is introduced into the solution at a concentration of from 0.001 μg / ml to 0.03 μg / ml, and a concentration below 0.001 μg / ml does not lead to a pronounced antihypoxic effect, and a concentration above 0.03 μg / ml can cause conjunctival hyperemia. Cytochrome C is used in finished form (FS 42-2535-88).

 The proposed balanced saline solution for ophthalmology is obtained by known technology, for which exact weights of the components are dissolved in deionized pyrogen-free water in any order, filtered through a filter with a pore size of 0.22 μm and Packed in bottles of various capacities, corking them with stoppers.

 Example 1

 Patient D., 60 years old.

 Diagnosis: immature cataract of the left eye.

 Visual acuity of 0.04 is not correctable.

The patient underwent cataract extraction by phacoemulsification using the described solution of the following composition, wt.%:
Sodium Chloride - 0.85
Disubstituted Sodium Phosphate - 0.04
Monosubstituted sodium phosphate - 0.005
Glycosaminoglycans - 0.006
L-carnosine - 0.05
Cytochrome C - 0.01
Water - Else
The irrigation volume was 110 ml.

 The operation and the postoperative period without complications, with discharge, visual acuity of 0.8 with spherical correction + 14 D. Endothelial cell loss - 5.5%. The cornea is edematous.

 Example 2

 Patient D., 55 years old.

 Diagnosis: traumatic cataract of the right eye.

The patient underwent cataract extraction with implantation of an IOL model T-26 using the described solution of the following composition, wt.%:
Sodium Chloride - 1.0
Disubstituted sodium phosphate - 0.09
Monosubstituted Sodium Phosphate - 0.01
Glycosaminoglycans - 0.01
L-carnosine - 0.2
Cytochrome C - 0.03
Water - Else
The irrigation volume was 6 ml.

 The operation and the postoperative period without complications, with discharge, visual acuity of 0.6 with correction + 3.5 D. Loss of endothelial cells - 6%. The cornea is transparent and edematous.

 Example 3

 Patient D., 78 years old.

 Diagnosis: age-related cataract of the left eye.

The patient underwent cataract extraction with implantation of an IOL model T-19 using the described solution of the following composition, wt.%:
Sodium Chloride - 0.8
Disubstituted sodium phosphate - 0.01
Monosubstituted sodium phosphate - 0.001
Glycosaminoglycans - 0.002
L-carnosine - 0.002
Cytochrome C - 0.001
Water - Else
The irrigation volume was 3 ml.

 The operation and the postoperative period without complications, with discharge, visual acuity of 0.5 without correction. Endothelial cell loss - 7%.

 Of 300 patients operated on using a known solution, it was noted that during abdominal operations, the percentage of complications such as corneal edema, loss of endothelial cells, and inflammation is reduced.

Claims (1)

Ophthalmology irrigation solution, including sodium chloride, disodium substituted sodium phosphate, disubstituted sodium phosphate and water, characterized in that it additionally contains glycosaminoglycans, L-carnosine and cytochrome C, in the following ratio, wt.%:
Sodium Chloride - 0.8 - 1.0
Disubstituted sodium phosphate - 0.01 - 0.09
Monosubstituted sodium phosphate - 0.001 - 0.01
Glycosaminoglycans - 0.002 - 0.01
L-carnosine - 0.002 - 0.2
Cytochrome C - 0.001 - 0.03
Water - The rest