Eye transplantation

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Eye transplantation
SpecialtyOphthalmology, neurosurgery
ComplicationsTransplant rejection

Eye transplantation is the transplantation of the globe of the human eye from a donor to a recipient.

Research directions

Research efforts in whole eye transplantation (WET) are focused on its application in living human recipients, still some obstacles need to be addressed. Apart from the surgical and neurological considerations, there are key ethical concerns such as patients' perceptions and desires for both nonvision-restoring WET and vision-restoring WET, risks and benefits compared to prosthetic alternatives, psychosocial considerations for potential recipients regarding personal identity related to the donor's eyes, public perceptions of whole-eye donation, implications for corneal transplantation eligibility of the donor's eyes, consent for whole-eye donation, and establishment of ethical mechanisms for allocation and distribution of WET. With limited studies available on this topic since the first vascularized composite allotransplantation (VCA)[1][2][3] took place in 1998, the understanding of WET is informed by a few studies with limitations. For example, amphibian regeneration cannot directly apply to humans. Ocular transplants may offer a viable option for restoring form in patients undergoing facial transplantation with enucleated orbits.[4]

History

In 1885, the Revue générale d'ophtalmologie reported that the staphylomatous and buphthalmic eye of a 17-year-old girl had been replaced by the eye of a rabbit by a Dr. Chibret.[5][6] The operation failed after 15 days due to a lack of effective immunosuppression.[6]

In 1969, Conrad Moore of the Texas Medical Center claimed that he had carried out the transplantation of a whole eye, but he subsequently retracted his claim.[7]

In November 2023, surgeons at NYU Langone Health announced the first successful eye transplantation,[8] which was carried out as part of a partial face transplant in an operation that took 21 hours.[8] The recipient, Aaron James, had lost the left side of his face with his eye, nose and mouth in a high-voltage power line accident.[8] Reuters reported that the transplanted eye has "well-functioning blood vessels and a promising-looking retina".[8] The eye is not using the optic nerve to communicate with the brain, and James has not regained sight through the eye.[8] Adult stem cells have been harvested from his bone marrow and been injected into the optic nerve.[8] The lead surgeon, Eduardo D. Rodriguez, said that "If some form of vision restoration occurred, it would be wonderful, but ... the goal was for us to perform the technical operation".[8]

See also

References

  1. ^ Brandacher G (October 2018). "Vascularized composite allotransplantation: a field is maturing". Curr Opin Organ Transplant. 23 (5): 559–560. doi:10.1097/MOT.0000000000000574. PMID 30080699.
  2. ^ Toyoda Y, Levin LS (December 2023). "What is needed to ensure long-term sustainability for the field of vascularized composite allotransplantation?". Curr Opin Organ Transplant. 28 (6): 446–451. doi:10.1097/MOT.0000000000001114. PMID 37767962. S2CID 263098961.
  3. ^ Zor F, Karagoz H, Kapucu H, Kulahci Y, Janjic JM, Gorantla VS (December 2019). "Immunological considerations and concerns as pertinent to whole eye transplantation". Curr Opin Organ Transplant. 24 (6): 726–732. doi:10.1097/MOT.0000000000000713. PMID 31689262. S2CID 207896485.
  4. ^ Laspro M, Chaya BF, Brydges HT, Dave N, Thys E, Onuh OC, Tran D, Kimberly LL, Ceradini DJ, Rodriguez ED (April 2023). "Technical Feasibility of Whole-eye Vascular Composite Allotransplantation: A Systematic Review". Plast Reconstr Surg Glob Open. 11 (4): e4946. doi:10.1097/GOX.0000000000004946. PMC 10129168. PMID 37113307.
  5. ^ Maddela NR, Chakraborty S, Prasad R (2021-03-22). Nanotechnology for Advances in Medical Microbiology. Springer Nature. p. 45. ISBN 978-981-15-9916-3.
  6. ^ a b Sher Y, Maldonado JR (2018-11-22). Psychosocial Care of End-Stage Organ Disease and Transplant Patients. Cham: Springer. ISBN 978-3-319-94914-7.
  7. ^ Blodi CF (2022). "Novel Insights Into the 1969 Whole-Eye Transplant: Medical Ethics and Evolving Safety Mechanisms". American Journal of Ophthalmology. 238: 120–127. doi:10.1016/j.ajo.2022.01.009. PMID 35038417. S2CID 245982243.
  8. ^ a b c d e f g Lapid N (9 November 2023). "Surgeons in New York announce world's first eye transplant". Reuters. Retrieved 10 November 2023.
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