How far has modern science progressed? The world’s first whole-eye transplant

A hundred years ago, the idea of having standard operating procedures for transplanting someone’s blood, let alone someone else’s organs, seemed like something society would have achieved by the time there were flying cars. However, modern science and lab studies are moving fast and furiously, and one of the most surprising evidence of their progression is the case of Aaron James, an ordinary 47-year-old father who received the first successful whole-eye transplant, ever. 

In 2021, James accidentally touched a live wire while working as a lineman in an electrical company. Along with losing his dominant left arm, left eye, chin, and nose, James also lost the ability to eat solid food, taste, smell, or talk normally. When it seemed like James’ quality of life would remain burdened by his disabilities, he received the first whole-eye and face transplant, thanks to New York University (NYU) Langone Hospital and an eyeball donor. In May 2023, a large healthcare team gave James a left eye, its surrounding bony socket, the nose, some chin bone fragments and its associated muscles, and nerves and blood vessels from a donor whose brain showed no function. Surgeon Daniel Ceradini, a member of James’ operating team, told Nature that doctors were not optimistic about James regaining sight in the transplanted eye, since they did not think the donor’s optic nerve could successfully connect itself to James’ brain. It’s still unknown how to regenerate the optical nerve system, but the operation certainly brought the medical field one step closer to an eye surgery that could someday restore vision.

Prior to the surgery, the operating team practiced surgical eye dissection on cadavers at least 15 times. The team created an entirely new operation using existing principles and known information. One major challenge the team faced with developing this procedure was that the blood flow to the eyes comes from a different artery than what serves the rest of the face. To make sure the donated eye didn’t lose blood supply for too long, the surgeons connected the artery supplying the donor’s eye to a branch of the donor’s external carotid artery, located in the neck. 3D-printed surgical guides were also created to tell the surgeons the precise amount of donor bone needed to fit James’ face.

After a grueling 21 hours, James’ operation was complete. Upon waking up, James could smell for the first time in the two years since the accident. He reported feeling an itching sensation deep within his eye socket and regained feeling around the eye. Tests in electroretinography showed that his left retina had a photoreceptor response, implying that the eye’s rods and cones were still intact post-transplant. According to NYU Langone Health, the electric response by the photoreceptor converts light into signals that ultimately the brain can interpret for vision, which opens the possibility of whole-eye transplants that resource vision.

It’s been over a year since James’ surgery, and his transplanted eye is still healthy. While the vision in his left eye has yet to return, its retina still responds to light.

“The successful results of James’ eye transplant open the door to even more research efforts towards the optic nerve and consequent vision restoration.”

The successful results of James’ eye transplant open the door to even more research efforts towards the optic nerve and consequent vision restoration. Since the optic nerve is part of the central nervous system, future surgical explorations could include brain or spinal cord regeneration. If spinal cord regeneration can be achieved, who knows what other core bodily functions can be restored in the future?