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By Chloe Kim
BBC News
Surgeons in New York say they have performed the world’s first complete eye transplant on a man, although it is not certain he will regain vision.
Aaron James, who survived a high-voltage electrical accident, underwent 21 hours of surgery that replaced half of his face.
Surgeons have been able to transplant corneas successfully for years.
Experts have called the breakthrough a pivotal moment in the quest to restore sight to millions of people.
Mr James, a high-voltage utility line worker from Arkansas, lost most of his face when it accidentally touched a 7,200-volt live wire in 2021.
On 27 May this year, he underwent a rare partial face transplant in addition to the eye transplant – which involved more than 140 healthcare professionals.
Surgeons at NYU Langone Health, who performed the complicated surgery, said on Thursday that Mr James, 46, was recovering well from the dual transplant and the donated eye looked remarkably healthy. His right eye still works.
“The mere fact that we’ve accomplished the first successful whole-eye transplant with a face is a tremendous feat many have long thought was not possible,” said Dr Eduardo Rodriguez, one of the leading surgeons on the team. “We’ve made one major step forward and have paved the way for the next chapter to restore vision.”
Doctors say James’ surgery offers scientists an unprecedented window into how the human eye tries to heal.
“We’re not claiming that we are going to restore sight,” Dr Rodriguez told ABC News. “But there’s no doubt in my mind we are one step closer.”
Doctors said there was direct blood flow to the retina – the part of the eye that sends images to the brain. While there is no certainty Mr James will regain vision in his new eye, doctors do not rule out the possibility either.
“If I can see out of it, that’s great,” Mr James said in an interview. “But if it’ll kick-start the next path in the medical field, then I’m all for it.”
Mr James, a military veteran, will continue to be monitored by doctors, but the progress they have seen with the eye is “exceptional” says Bruce E. Gelb, MD, a transplant surgeon at New York University.
The donated face and eye came from a single male donor in his 30s. During the surgery, doctors injected adult stem cells from the donor’s bone marrow into the optic nerve to encourage its repair.
Categories: Health
During James’ 21-hour operation, surgeons added another experimental twist: When they spliced together the donated optic nerve to what remained of James’ original, they injected special stem cells from the donor in hopes of spurring its repair.
Last month, tingles heralded healing facial nerves. James can’t yet open the eyelid, and wears a patch to protect it. But as Rodriguez pushed on the closed eye, James felt sensation — although on his nose rather than his eyelid, presumably until slow-growing nerves get reoriented. The surgeon also detected subtle movements beginning in muscles around the eye.
Then came a closer look. NYU ophthalmologist Dr. Vaidehi Dedania ran a battery of tests. She found expected damage in the light-sensing retina in the back of the eye. But she said it appears to have enough special cells called photoreceptors to do the job of converting light to electrical signals, one step in creating vision.
Normally, the optic nerve then would send those signals to the brain to be interpreted. James’ optic nerve clearly hasn’t healed. Yet when light was flashed into the donated eye during an MRI, the scan recorded some sort of brain signaling.
That both excited and baffled researchers, although it wasn’t the right type for vision and may simply be a fluke, cautioned Dr. Steven Galetta, NYU’s neurology chair. Only time and more study may tell.
https://www.npr.org/2023/11/10/1212067302/arkansas-man-receives-the-worlds-first-whole-eye-transplant-plus-a-new-face#:~:text=NEW%20YORK%20%E2%80%94%20Surgeons%20have%20performed,James'%20face%20and%20one%20eye.