2023-11-09 20:34:00
Dr. Eduardo Rodriguez of NYU Langone Health operates on Aaron James, in the first full eye transplant performed on a human patient, in New York in May 2023 (NYU Langone Health / Joe CARROTTA)
This is a world first bringing hope for people who have lost the use of one eye: American surgeons announced Thursday that they had carried out the first transplant of a complete eye on a patient, who however did not recover the view — at least for the moment.
Just over five months after surgery, the patient’s eye still shows signs of very good health, including blood flow to the retina. Results that leave experts “stunned,” Dr. Eduardo Rodriguez, who led the procedure, said at a press conference.
“There are millions of people who have lost their sight, and we’re not saying we’re going to solve this today,” the surgeon said. “But we’re definitely a little bit closer.”
The operation lasted approximately 21 hours, and was carried out at the end of May by a team from NYU Langone Health University Hospital in New York.
In addition to the left eye and its socket, surgeons also transplanted the nose, lips and other facial tissue taken from a donor.
The recipient patient, Aaron James, suffered a workplace accident in 2021 that could have cost him his life, when his face hit a high-voltage power line.
As he had to, no matter what, take immunosuppressants to avoid rejection of the grafts performed on his face, this former soldier was an ideal candidate to attempt an eye transplant.
– “Huge progress” –
Aaron James, whose right eye still functions normally, appeared during the press conference with his face completely uncovered, his left eye closed under his eyelid (which he cannot yet move naturally).
“Whether I can see or not, that’s the way it is,” he said, thanking the donor and his family. “You have to start somewhere, and I hope this will initiate something that we can improve for the next patient.”
“I can smell and eat again,” he told AFP, adding that he wanted to “go out in public” again. “For the first time in a year and a half, I was able to kiss my wife.”
Could it be that the transplanted eye will subsequently regain vision?
Aaron James, who received the first full eye transplant, and his wife in New York after surgery, in a photo provided by NYU Langone Health (NYU Langone Health/Handout)
“In medicine, you never like to say never,” replied Vaidehi Dedania, a retina specialist at NYU Langone Health. “We will continue to follow it, and see how things evolve. But we have a lot of hope.”
“A large part of the retina is preserved, and our tests show that it is capable of generating a signal,” she detailed.
The doctors did not expect such good results, and a team was urgently formed to explore the different avenues that could help restore sight.
Aaron James, who was aware that this operation could only have an aesthetic benefit for him, has now been able to return to live in Arkansas with his wife and daughter, and returns to New York every month for appointments. you tracking.
This is a “remarkable achievement”, which marks an important step towards “the ultimate goal of restoring vision”, commented for AFP Daniel Pelaez, associate professor of ophthalmology at the University of Miami.
“This is a huge step forward,” added surgeon Kia Washington, who has been working on this problem for 10 years at the University of Colorado. “So many people still doubted” that such a transplant “was possible in humans.”
– Nerve connection –
The main difficulty of an eye transplant is to restore the transmission of information to the brain via the optic nerve. This is in fact cut in both the patient and the donor to carry out the graft.
In the past, whole eye transplants had already been performed on small animals, whose vision was at least partially restored in some cases, explained surgeon Kia Washington.
But succeeding in achieving this in humans will require combining “many different methods”, according to her. Among those cited by the specialist as future avenues: gene therapy, the use of stem cells, or even the preparation of the recipient’s brain via electrical stimulation.
In Aaron James’ case, stem cells from the donor’s spinal cord were also injected into the patient’s optic nerve, in the hope of improving its regeneration.
Will it one day be possible to give sight to a person blind from birth through a transplant? This is still a distant horizon, replies Kia Washington. But “I think yes, it will happen in the coming decades.”
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