The first ever transplantation of a complete human eye has been successfully performed by surgeons in New York. This groundbreaking procedure was added to a face transplant, but its effectiveness in restoring vision is still uncertain.
Aaron James suffered severe facial and eye damage from an incident involving high-voltage power lines. While his right eye remains functional, surgeons at NYU Langone Health aimed to improve the appearance of his reconstructed face by replacing his missing eye, which would also provide support for the transplanted eye socket and eyelid.
On Thursday, the NYU team reported that they have successfully achieved their goal. James is making a good recovery after his double transplant in May and the transplanted eye appears to be in excellent condition.
“It’s a positive feeling. I still don’t have any mobility in it at the moment. My eyelid is still unable to blink. However, I am starting to regain sensation,” James shared with The Associated Press during a recent examination by doctors.
James, a 46-year-old resident of Hot Springs, Arkansas, stated that everyone has to begin somewhere and there will always be a first person. He also mentioned that one might gain knowledge from their experience that could benefit others in the future.
Currently, corneal transplants, which involve replacing the clear tissue at the front of the eye, are frequently used to treat specific forms of vision impairment. However, the transplantation of an entire eye, including the eyeball, its blood supply, and the crucial optic nerve that connects it to the brain, is seen as a major challenge in the pursuit of curing blindness.
Regardless of the outcome, James’ surgery will provide scientists with an unparalleled opportunity to observe the healing process of the human eye.
Dr. Eduardo Rodriguez, the plastic surgery chief at NYU who led the transplant, stated that their goal is not to guarantee restored sight. However, he believes that they have taken a step forward in achieving this goal.
Experts were concerned that the eye would rapidly decrease in size, resembling a dried grape. However, when Rodriguez opened James’ left eye in the previous month, the hazel-colored donated eye was just as full and watery as his own blue eye. Medical professionals observed positive blood circulation and no indications of rejection.
Currently, scientists are studying the scans of James’ brain which revealed unusual signals from the damaged optic nerve, a crucial component.
A researcher with extensive knowledge in eye transplant research has described the procedure as thrilling.
Dr. Jeffrey Goldberg, chair of ophthalmology at Stanford University, described it as a remarkable confirmation of the effectiveness of animal experiments in preserving transplanted eyes.
According to Goldberg, the challenge lies in finding a way to regenerate the optic nerve. However, progress is being made through animal studies. He commended the NYU team for their boldness in attempting to repair the optic nerve and believes that the transplant will inspire further research.
“We are very close to being able to accomplish this,” Goldberg stated.
In June 2021, James was employed by a power line company when he suffered an electric shock from a live wire. The incident was life-threatening and resulted in the loss of his left arm. He had to use a prosthetic to replace it. Due to the severity of the shock, his left eye had to be removed due to the extreme pain. Despite undergoing several reconstructive surgeries, his face sustained significant damage, including the loss of his nose and lips.
James persevered through his sessions of physical therapy until he regained enough strength to accompany his daughter Allie to her high school homecoming event while wearing a face mask and eye patch. However, he still needed assistance with breathing and eating through tubes and yearned to experience the pleasures of smelling, tasting, and consuming solid foods once more.
Meagan James, the wife of the man without a nose, expressed that she didn’t mind his physical appearance in her mind and heart, but she did care that it was a source of discomfort for him.
Face transplants remain rare and risky. James’ is only the 19th in the U.S., the fifth Rodriguez has performed. The eye experiment added even more complexity. But James figured he’d be no worse off if the donated eye failed.
After waiting for three months, James was finally matched with a donor on the national transplant list. The donor, a man in his 30s, provided kidneys, a liver, and pancreas to save the lives of three other individuals.
During James’ 21-hour surgery, doctors incorporated a new experimental element: They inserted specialized stem cells from the donor into the spliced optic nerve, in the hopes of promoting its healing.
In the previous month, tingling sensations indicated that the facial nerves were starting to heal. James is still unable to fully open his eyelid and wears a patch for protection. However, when Rodriguez applied pressure to his closed eye, James could feel some sensation, albeit on his nose instead of his eyelid. This is likely due to the nerves gradually adjusting. The surgeon also noticed slight movements in the muscles around the eye.
Afterwards, a more thorough examination was conducted. Dr. Vaidehi Dedania, an ophthalmologist at NYU, administered a series of tests. She discovered the anticipated harm in the light-receiving retina at the rear of the eye. However, she stated that there seems to be a sufficient amount of specialized cells known as photoreceptors to perform the task of converting light into electrical signals, which is one step in the process of creating vision.
The usual process is for the optic nerve to transmit these signals to the brain for processing. However, James’ optic nerve has not fully recovered. Surprisingly, when light was directed into the transplanted eye during an MRI, brain activity was detected.
The discovery both intrigued and puzzled scientists, although it may not be relevant to vision and could just be a coincidence, warned Dr. Steven Galetta, the chair of neurology at NYU. Only further research and time will reveal the truth.
However, according to Dr. David Klassen, the chief medical officer of the United Network for Organ Sharing, who oversees the transplant system in the country, the surgery is a remarkable feat of technical skill. He also added that a single transplant can provide valuable insights for advancing the field.
James stated that they are taking things one day at a time.
The Howard Hughes Medical Institute’s Science and Educational Media Group provides support to the Associated Press Health and Science Department. The AP is solely responsible for the content of the department.