Surgeons have given a human an entirely new eye for the first time in a groundbreaking new addition to facial transplant procedures.
The recipient, Arkansas native Aaron James, lost his left eye and half his face when he survived a deadly 7,200-volt electric shock in June 2021. The 46-year-old military veteran was working as a lineman when his face accidentally touched a live wire, also causing extensive injuries to his dominant left arm above the elbow, his nose, lips, teeth, cheek and chin down to the bone.
Just two months later, the NYU Langone team met James, and they started to discuss and evaluate facial transplants. Then on May 27, 2023, a team of more than 140 surgeons, nurses and other health care professionals led a 21-hour surgery to give James his face back, including a new eye in a world first.
The procedure used an entire left eye and a portion of a face from a single donor, also marking the first time these have successfully been combined in any transplant case.
It's still unclear whether James will regain sight in his new left eye, but it's showing "remarkable signs of health," including direct blood flow to the retina, NYU Langone said.
@scrippsnews A U.S. military veteran is the first person to undergo the world's first whole-eye #transplant. The procedure took around 21 hours and involved 140 health professionals. #healthtok ♬ original sound - Scripps News
"Aaron has been extremely motivated to regain the function and independence he lost after his injury. We couldn't have asked for a more perfect patient," said Dr. Eduardo Rodriguez, who led the NYU Langone team. "This achievement demonstrates our capacity to embrace the most difficult challenges and drive continuous advancements in the field of transplantation and beyond."
The decision to do the procedure came after surgeons had to remove James' left eye due to his severe pain. Dr. Rodriguez and his crew recommended the optic nerve length be preserved in hopes of using it in a potential transplant, which then began a discussion of including an eye with the facial transplant for the first time — if even just for cosmetic purposes.
Even if James had just gotten the face transplant, he still would have been undergoing a rare procedure; fewer than 50 have been performed worldwide since the first one in 2005, and five have been performed under Dr. Rodriguez's lead.
Though corneal transplants have become more common, with thousands performed each year, the concept of the eye transplant had to be intricately planned by the NYU Langone team due to the complex nature of the organ. They ended up injecting bone marrow-derived adult stem cells from the donor patient into James' optic nerve to help nerve regeneration, in another first.
Some doctors feared the eye would just shrivel up, but there are currently no signs of rejection. Plus, there appears to be some sort of sign of brain signaling.
The NYU Langone team says the feat doesn't mean they believe their tactic will restore James' sight, but they believe these signs makes them one step closer.
"We've made one major step forward and have paved the way for the next chapter to restore vision," Dr. Rodriguez said.
And even though James can't yet open his eyelid, he feels sensations, and Rodriguez is seeing subtle muscle movements around the eye.
"You got to start somewhere, there's got to be a first person somewhere," James told The Associated Press. "Maybe you'll learn something from it that will help the next person."
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