A bisulfite-free intraocular epinephrine solution.

Abstract

We evaluated a preservative-free, sulfite-free epinephrine solution for potential corneal toxicity, which has been described for sulfite-containing epinephrine solutions. The preservative-free, sulfite-free epinephrine solution did not exhibit endothelial toxicity in three-hour paired human corneal endothelial perfusion at two and four times the concentration of the 1:1,000,000 dilution currently recommended for anterior chamber intraocular irrigating solutions. When epinephrine at a dilution of 1:1,000 was injected directly into the anterior chamber of New Zealand white rabbits, there was markedly less corneal edema induced than there was in previous studies with sulfite-containing solutions of comparably low pH but higher buffer capacities. Although potential toxicity exists for any irrigating solution with a pH outside of the 6.5 to 8.5 pH range, the endothelial toxicity of this solution has been reduced by its low buffer capacity, lack of preservatives, and lack of sulfite, offering an extra margin of safety for intraocular use.