A 46-year-old patient underwent a full eye and partial face transplant at New York University Langone Medical Center in the United States. After a year of postoperative recovery, the transplanted eye remained healthy, the retina could respond to light, and vision was partially restored. Although vision was not fully restored, eye pressure and blood flow were normal, exceeding expectations in previous animal studies. The groundbreaking study is described in an issue of the Journal of the American Medical Association.
Whole-eye transplantation has long been a goal pursued by doctors and scientists. This pioneering transplant operation pushes the boundaries of reconstructive surgery and transplant medicine, opening up new possibilities for treating severe facial injuries and restoring vision through transplantation. The success of the surgery is expected to promote further development of complex transplants involving key sensory organs.
The patient, Aaron James, was working as an electrician in June 2021 when he suffered an electrical accident and lost his dominant left arm, left eye, jaw and nose. For two years, he was unable to eat solid food, taste, smell or speak properly.
In May 2023, a large medical team transplanted James' entire left eye, eye socket, nose, a jaw bone, and associated muscles, nerves, and blood vessels. The operation took about 21 hours.
Daniel Seradini, a surgeon at New York University Langone Medical Center and author of the study, said they never expected James' transplanted eye to partially restore vision because there was no evidence that the donor's optic nerve could successfully connect to James' brain. The optic nerve is a part of the central nervous system that carries information from the retina to the brain. How to regenerate this system is still a mystery, but this surgery brings researchers one step closer to their goal.
Jeffrey Goldberg, professor and director of ophthalmology at Stanford University's Byers Eye Institute in the United States, commented in the same journal that it is not surprising that vision has not been fully restored, because animal pre-clinical studies have shown that it is very difficult to regenerate the optic nerve.
He said the surgical team injected stem cells from James' bone marrow into the tissue surrounding the optic nerve, a technique that has not been proven in animals and could pose a safety risk if the cells grow into tumors. Fortunately, that has not happened so far. Another risk is that if the optic nerve in the donated eyeball regenerates, it could damage James' vision in the other eye because the input from the two eyes can interact in the brain. However, there is no sign of such complications either. Goldberg said the treatment results in the *** case were exciting and laid the groundwork for restoring vision through a full eye transplant.