A team of surgeons in New York has performed the world’s first transplantation of a whole eye. This procedure was recognized as a breakthrough in medicine, although it is not yet known whether the man will ever be able to see through the donor eye. The groundbreaking surgery involved removing part of the face and the entire left eye, including its blood supply and optic nerve, from a donor and transplanting them into an Arkansas line worker who survived a 7200-volt electric shock in June 2021.
Aaron James, 46, sustained significant injuries, including the loss of his left eye, left arm above the elbow, nose and lips, front teeth, left cheek and chin. He was referred to NYU Langone Health, a leading medical center for facial transplantation, which performed the procedure on May 27. Whole-eye transplantation has long been the holy grail of medical science, and while researchers have had some success in animals where they have partially restored vision, it has never been done in a living person.
“It’s uncharted territory, but we’re looking forward to exploring,” Eduardo Rodriguez, who led the operation, told AFP.
This was Rodriguez’s fifth face transplant, and “we’ve managed to reduce the time since I started in 2012 from 36 hours to 21,” he said, adding that face transplants are no longer an experimental procedure and should be considered. standard of care” in some cases of serious distortion.
The transplanted left eye seems to be very healthy, said retinal ophthalmologist Vaydehi Dedania. It is well supplied with blood, maintains its pressure and generates an electrical signal, although James cannot yet see. “But we have a lot of hope,” she added.
A great cause
“It’s a huge deal,” Kia Washington, a professor of surgery at the University of Colorado Anschutz Medical Campus who has been working in the same field for 15 years, told AFP, praising her colleagues.
Daniel Pelaez of the Bascom Palmer Institute at the University of Miami, who is also working toward the same goal, told AFP: “The human eye transplant at NYU Langone is a key moment in our shared quest to restore sight and gives hope to countless people around the world.”
James, whose right eye remained intact, was considered an ideal candidate because his need for a face transplant meant he would still need immunosuppressants. This meant that an attempt at eye transplantation would have been worthwhile, even if it had only cosmetic value.
“I can smell again, I can eat again, I can taste food. For the first time in a year and a half, I had to kiss my wife,” he told AFP. “I want to go out in public now, not wear a mask and not hide behind it.”
“I want as many people as possible who may not know about this option, especially the eye, to know about it,” he continued. “Even if it didn’t work for me, it was a start, so maybe Dr. Rodriguez could learn something different to do next time.”
Regeneration of the optic nerve
Given the time that has passed since the surgery, Washington said she doesn’t think James’ eye will regain its sight, but “I never say anything is impossible,” she added.
The Langone team at New York University said they used adult stem cells derived from bone marrow to promote nerve repair.
Achieving the goal of restoring vision may involve other advanced approaches, Washington said, including gene therapy to tap into the optic nerve’s intrinsic ability to heal; using a device called a nerve wrap to protect the tissue; or using devices that pick up signals and bypass the damaged pathway.
“We are making significant progress in treatments to promote optic nerve regeneration that can accompany eye transplantation,” Jeffrey Goldberg, who leads similar efforts at the Byers Institute of Vision at Stanford University, told AFP.
“This adjunctive therapy will allow the donor eye to connect with the brain in a meaningful way and restore meaningful visual function for blind patients around the world.”
