[NJTechDiv] Surgeons have performed the world’s first eye transplant.

[Mario Brusco]

Surgeons have performed the world’s first eye transplant.
https://apnews.com/article/face-transplant-experimental-eye-nyu-0d88cbb9d6190c64b53c01fafb9c2d9f?utm_campaign=TrueAnthem&utm_medium=AP&utm_source=Twitter

BY Lauran Neergaard, Updated 12:52 PM EST, November 9, 2023.

NEW YORK (AP), Surgeons have performed the world’s first transplant of 
an entire human eye, an extraordinary addition to a face transplant, 
although it’s far too soon to know if the man will ever see through his 
new left eye.

An accident with high-voltage power lines had destroyed most of Aaron 
James’ face and one eye. His right eye still works. But surgeons at NYU 
Langone Health hoped replacing the missing one would yield better 
cosmetic results for his new face, by supporting the transplanted eye 
socket and lid.

The NYU team announced Thursday that so far, it’s doing just that. James 
is recovering well from the dual transplant last May and the donated eye 
looks remarkably healthy.

“It feels good. I still don’t have any movement in it yet. My eyelid, I 
can’t blink yet. But I’m getting sensation now,” James told The 
Associated Press as doctors examined his progress recently.

“You got to start somewhere, there’s got to be a first person 
somewhere,” added James, 46, of Hot Springs, Arkansas. “Maybe you’ll 
learn something from it that will help the next person.”

Today, transplants of the cornea, the clear tissue in front of the eye, 
are common to treat certain types of vision loss. But transplanting the 
whole eye, the eyeball, its blood supply and the critical optic nerve 
that must connect it to the brain, is considered a moonshot in the quest 
to cure blindness.

Whatever happens next, 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,” said Dr. 
Eduardo Rodriguez, NYU’s plastic surgery chief, who led the transplant. 
“But there’s no doubt in my mind we are one step closer.”
Some specialists had feared the eye would quickly shrivel like a raisin. 
Instead, when Rodriguez propped open James’ left eyelid last month, the 
donated hazel-colored eye was as plump and full of fluid as his own blue 
eye. Doctors see good blood flow and no sign of rejection.

Now researchers have begun analyzing scans of James’ brain that detected 
some puzzling signals from that all-important but injured optic nerve.

One scientist who has long studied how to make eye transplants a reality 
called the surgery exciting.

“It’s an amazing validation of animal experiments that have kept 
transplanted eyes alive”, said Dr. Jeffrey Goldberg, chair of 
ophthalmology at Stanford University.

“In his mind and his heart, it’s him, so I didn’t care that, you know, 
he didn’t have a nose. But I did care that it bothered him,” Meagan says.

The hurdle is how to regrow the optic nerve, although animal studies are 
making strides, Goldberg added. He praised the NYU team’s “audacity” in 
even aiming for optic nerve repair and hopes the transplant will spur 
more research.

“We’re really on the precipice of being able to do this,” Goldberg said.

James was working for a power line company in June 2021 when he was 
shocked by a live wire. He nearly died. Ultimately he lost his left arm, 
requiring a prosthetic. His damaged left eye was so painful it had to be 
removed. Multiple reconstructive surgeries couldn’t repair extensive 
facial injuries including his missing nose and lips.

James pushed through physical therapy until he was strong enough to 
escort his daughter Allie to a high school homecoming ceremony, wearing 
a face mask and eye patch. Still he required breathing and feeding 
tubes, and longed to smell, taste and eat solid food again.

“In his mind and his heart, it’s him, so I didn’t care that, you know, 
he didn’t have a nose. But I did care that it bothered him,” said his 
wife, Meagan James.
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.

Three months after James was placed on the national transplant waiting 
list, a matching donor was found. Kidneys, a liver and pancreas from the 
donor, a man in his 30s, saved three other people.

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.
after a facial and eye transplant. The NYU team announced Thursday, Nov. 
9, 2023, that so far, James is recovering well from the dual transplant 
in May and the donated eye looks remarkably healthy.

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.

Still, the surgery marks “a technical tour de force,” said Dr. David 
Klassen, chief medical officer of the United Network for Organ Sharing, 
which runs the nation’s transplant system. “You can learn a tremendous 
amount from a single transplant” that could propel the field.

As for James, “we’re just taking it one day at a time,” he said.
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