Over 1 million Americans and more than 40 million people worldwide can’t see out of both eyes (with visual acuity below 20/200). Another 3 to 5 times as many have poor eyesight. Blindness remains one of the worst conditions experienced by any human.
For the main causes (including glaucoma and other optic nerve problems, age-related and other macular issues, and diabetic eye disease) as well as less common reasons (like injuries or lack of blood flow along the visual pathways), no treatments exist to bring back sight. Most types of permanent blindness involve losing specific eye cells that don’t grow back or, in bad injuries, losing the whole retina optic nerve, or eye. Scientists were busy finding stem cell treatment, but an eye transplant remains the best treatment way to fix vision loss.
Even with progress in eye research and immune system studies of the eye, no one has transplanted an eye yet. Several hurdles need to be overcome careful planning to get the eye parts keeping the eye (the retina and optic nerve) alive from when it’s taken from the donor to when it’s put in the recipient putting it in and connecting the donor and recipient optic nerves and using drugs to stop the body from rejecting the new eye.
This issue of JAMA features Ceradini and colleagues’ report on the first hemifacial transplant that included an eye. For almost two decades, doctors have used hemifacial transplants without eyes to reconstruct complex cases and improve looks. These procedures have been essential to boost mobility, mental health, and overall life quality for patients. This kind of transplant moves skin muscles, bone, nerves from one patient to another.
Ceradini’s team took it a step further by adding the whole eye optic nerve, eye muscles, and nearby tissues to the mix.
Three medicines—tacrolimus, mycophenolate mofetil, and prednisone—played a role in suppressing the immune system, following typical after-surgery care plans. The doctors wrote down every step of the tailored operation in depth covering both how they mapped it out and carried it out. A statement from the patient sheds light on how this successful surgery changed a life for the better.
The Advanced Research Projects Agency for Health asked for ideas on a “moonshot” project to make complete human eye transplants a reality. This has prompted scientists to work together to create medicines and supporting devices to help achieve this promising goal. Until these additional treatments prove themselves further, we should advise against moving forward too for patient safety. Yet even with its limits, this case brings excitement as a first-time event giving new life to efforts toward this ambitious target on the path to future scientific breakthroughs.
Reference:
Goldberg JL. Bringing Eye Transplant into the Light. JAMA [Internet]. 2024 [cited 2024 Sep 10]; Available from: https://jamanetwork.com/journals/jama/fullarticle/2823418?guestAccessKey=309c7f6f-0571-4b41-8fe7-7a44694d9bc5&utm_source=silverchair&utm_medium=email&utm_campaign=article_alert-jama&utm_content=olf&utm_term=090924&adv=000004166287
