Doctors hail world’s first eye transplant – even though patient can’t see
Doctors are “truly amazed” by the results of the world’s first eye transplant, despite the patient being unable to see out of the donated organ.
Aaron James, a worker on high-voltage lines, survived a 7,200-volt electric shock in June 2021 and lost much of the left side of his face, including his nose, lips, front teeth and eye as well as his left arm.
The 42-year-old Arkansas native and 10-year military veteran underwent a 21-hour operation in May 2023 during which he had a half-face transplant, which included an entire eye, from a brain-dead male donor in his 30s.
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It was the first time a whole-eye transplant had been performed in medical history and included a retina and optic nerve as well as some blood vessels.
Scientists and doctors who performed the pioneering work provided an update on the procedure in the medical journal Jama, saying the transplant had not been rejected, something never before managed.
Dr Eduardo Rodriguez, chairman of the Hansjorg Wyss department of plastic surgery at NYU Langone Health in the US, said: “We are truly amazed by Aaron’s recovery, with no episodes of rejection.”
They add that although Mr James is unable to see out of the transplanted organ, there are early signs of functionality, with the retina responding to light and indicators the brain is receiving some weak signals from the eye.
Doctors say this raises hope that one day, whole-eye transplants could be performed to restore sight.
Dr Daniel J Ceradini, director of research and associate professor at Hansjorg Wyss, said: “The whole thing has been a monumental achievement, considering how Aaron has done post-operatively and how good he functions and looks.”
Maintaining blood flow to the eye and its delicate tissues is a particular challenge of such a procedure, the scientists said, as well as ensuring the retina maintains its sensitivity to light and the nerves are healthy enough to send messages to the brain.
The one-year check-up revealed “several potentially positive findings”, the authors write, including good pressure in the eye itself as well as ample blood supply.
Dr Jeffrey Goldberg, professor and chairman of ophthalmology at the Byers Eye Institute at Stanford University, who was not involved with the procedure, said the MRI scans of Mr James’s brain showed that some signals from the eye were reaching the visual cortex of the brain.
Getting the optic nerve of the donor eye to communicate with the brain of the patient was, Dr Goldberg says, “the greatest barrier” stopping eye transplants going beyond just aesthetics and being able to restore vision.
This case study, he says, is “a tantalising data point” towards the hope of achieving this goal in future eye transplants.
“Even with its caveats, this case brings excitement and enthusiasm as an inaugural event, reinvigorating motivation for this lofty goal on the way to the next scientific advances,” Dr Goldberg wrote in an opinion article also published in Jama.
Despite not being able to see with his left eye, Mr James said he “felt honoured to be patient zero”.
‘Most transformative year of my life’
“The very first thing that I can remember when I woke up from surgery is being able to smell, because before that, I didn’t have a nose, so I couldn’t smell, and that also meant I could not taste anything,” he said. “This has been the most transformative year of my life.
“I’ve been given the gift of a second chance, and I don’t take a single moment for granted. I’ve gained my quality of life back, and I know this is a step forward in the path to help future patients.”
Mr James, who also lost his left arm in the accident and now wears a prosthetic, said that since surgery, he was “pretty much back to being a normal guy, doing normal things”.
Meagan James, 39, his wife of more than 20 years, said her emotional moment was when she kissed her husband on the lips for the first time in two years.
She said: “Just to have that back was pretty special.”
