For those who are interested…
https://apnews.com/article/face-transplant-experimental-eye-nyu-0d88cbb9d6190c64b53c01fafb9c2d9f?utm_campaign=TrueAnthemutm_medium=APutm_source=Twitter
Surgeons have performed the world’s first eye transplant
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.”
Other transplants in the US
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.”
This fall 2010 family photo shows Aaron James and his wife, Meagan, before his
June 2021 high-voltage electricity accident. (NYU Langone Health via AP)
Read More
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.
Image removed by sender. Aaron James speaks during an interview, accompanied by
his wife, Meagan, in New York on Oct. 23, 2023. “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. (AP Photo/Joseph. B. Frederick)Image
removed by sender. Aaron James speaks during an interview, accompanied by his
wife, Meagan, in New York on Oct. 23, 2023. “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. (AP Photo/Joseph. B. Frederick)
Aaron James speaks during an interview, accompanied by his wife, Meagan, in New
York on Oct. 23, 2023. “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. (AP Photo/Joseph. B. Frederick)
Read More
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.
Image removed by sender. This family photo shows Aaron James and his daughter,
Allie in September 2022. Aaron 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. (NYU Langone Health
via AP)Image removed by sender. This family photo shows Aaron James and his
daughter, Allie in September 2022. Aaron 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. (NYU Langone
Health
via AP)
This family photo shows Aaron James and his daughter, Allie in September 2022.
(NYU Langone Health via AP)
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.
This combination of photos provided by NYU Langone Health in November 2023
shows Aaron James before and after his high-voltage electricity accident and
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. (NYU Langone Health via AP)
Read More
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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