NEW ADVANCES IN OPHTHALMIC MICROSURGERY MAKE LOCAL EXCISION OF UVEAL MALIGNANT MELANOMAS A FEASIBLE ALTERNATIVE TO ENUCLEATION.

NEW ADVANCES IN OPHTHALMIC MICROSURGERY MAKE LOCAL EXCISION OF UVEAL MALIGNANT MELANOMAS A FEASIBLE ALTERNATIVE TO ENUCLEATION. THE TECHNIQUE INVOLVES PERFORMING A VITRECTOMY WHICH CREATES A NEED FOR A VITREOUS REPLACEMENT THAT WOULD SERVE ALSO AS A DRUG DELIVERY SYSTEM. THIS SYSTEM WOULD BE DESIGNED TO SIMULTANEOUSLY PROVIDE MAINTENANCE OF THE ANATOMICAL INTEGRITY OF THE EYE, BE OPTICALLY CLEAR AND GIVE SUSTAINED RELEASE OF AN ANTITUMOR DRUG TO DESTROY REMAINING NEOPLASTIC CELLS. THE POTENTIAL APPLICATION OF AQUEOUS, CRYSTAL CLEAR AND COLORLESS GELS OF PLURONIC POLYOL F-127R, A POLYOXYETHYLENE-POLYOXYPROPYLENE CO-BLOCK POLY- MER OF LOW TOXICITY, WILL BE STUDIED IN A TWO-PHASE PROGRAM FOR SUCH USE. THESE GELS EXHIBIT REVERSE THERMAL GELATION BEHAVIOR, GOOD SOLUBILIZATION CAPACITY, ARE EASY TO PREPARE AND ECONOMICAL IN COST. PHASE I STUDIES WILL BE DIRECTED TO CONFIRMING THE OCULAR COMPATIBILITY AND VITROUS REPLACEMENT FEASIBILITY OF THE GELS, EVALUATION AND OPTIMIZATION OF THE RELEASE OF ANTITUMOR DRUG, E.G., ACTINOMYCIN D, FROM THE GELS BASED ON IN VITRO RELEASE STUDIES AND THE DEVELOPMENT OF PROTOTYPE FORMULATIONS. PHASE II WILL CONSIST OF EXTENSIVE IN VIVO STUDIES OF THESE PROTOTYPE FORMULATIONS. SUCH A NOVEL APPROACH FOR COMBINING VITREOUS REPLACEMENT WITH DRUG DELIVERY MAY NOT ONLY ADVANCE INTRAOCULAR ANTITUMOR THERAPY, BUT SHOULD BE A SUITABLE VEHICLE AS WELL FOR OTHER THERAPEUTIC AGENTS INCLUDING ANTIBIOTICS.