Doctors Complete First Successful Face and Whole-Eye Transplant

An anonymous reader quotes a report from Scientific American: This week doctors announced they had completed the first successful transplant of a partial face and an entire eye. In May at NYU Langone Health in New York City, the surgery was performed on a 46-year-old man who had suffered severe electrical burns to his face, left eye and left arm. He does not yet have vision in the transplanted eye and may never regain it there, but early evidence suggests the eye itself is healthy and may be capable of transmitting neurological signals to the brain. The feat opens up the possibility of restoring the appearance -- and maybe even sight -- of people who have been disfigured or blinded by injuries. Researchers caution there are many technical hurdles before such a procedure can effectively treat vision loss, however.

'I think it's an important proof of principle,' says Jeffrey Goldberg, a professor and chair of ophthalmology at the Byers Eye Institute at Stanford University, who was not involved in the surgery but has been part of a team working toward whole-eye transplants in humans. 'I think it points to the opportunity and importance that we really stand on the verge of being able to [achieve] eye transplants and vision restoration for blind patients more broadly.'But he cautions that the main obstacle is achieving regeneration of the optic nerve, which carries visual signals from the retina to the brain; this step has not yet been successfully demonstrated in humans.

Scientists have been working toward whole-eye transplantation for many years. 'This has been, I would say, science fiction for a long time,' says Jose-Alain Sahel, a professor and chair of the department of ophthalmology at the University of Pittsburgh School of Medicine, who has been working toward such transplants with Goldberg and others. Progress in surgical techniques and nerve regeneration have made this goal seem more attainable. 'The fact that this surgery was successful is wonderful news,' Sahel says. He cautions that surgery is only a small part of the issues that need to be addressed in order to restore eye function, however. These include making sure the immune system doesn't reject the donor eye, which is a challenge with any type of transplant. Then the corneal nerve -- which carries sensory signals from the transparent part of the eye -- must be reconnected. Yet the most complex part is regenerating the optic nerve. In order to do so, surgeons have to coax the nerve fibers to grow to the right place, which Sahel says could take months or even years. And complete optic nerve regeneration has not yet been successfully achieved in humans or other mammals.

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