by Andy Corbley
Good News Network
An Iranian woman gained usable partial vision through a first-of-its kind surgery.
Sixty-seven-year-old Elena, who had been blind for several years, immediately gained enough vision to recognize both her son and her faithful canine companion, Joe.
From Turin comes this surgical world-first: the simultaneous transplant of a complete human macula, along with the cornea, sclera, and connective tissue, from one of the patient’s eyes to the other.
La Stampa, a Turin-based national newspaper, reported that the intervention was led by the “intuition” of ocular surgeon Professor Michele Reibaldi, who himself described the process as a “complicated marathon,” lasting 6 hours and requiring careful coordination by surgeons, anesthetists, and orderlies.
Elena lost her eyesight in a road incident which completely severed the optic nerve in her left eye. The optic nerve is responsible for transmitting light absorbed and delineated through the eye to the brain. The irreversible damage was not shared by the rest of eye tissues, which remained largely intact.
In an interesting coincidence, the reverse was true for her right eye. While the optic nerve was undamaged, the trauma of the crash destroyed other parts of her eye including the retina, the cornea, and the portion of the eye containing ocular stem cells, rendering a normal corneal transplant impossible.
In short, there was enough undamaged components between her two eyes to create one that could function. The only problem was that it would require a surgery never done in the history of medicine, a macular transplant.
The macula is a small, light-sensitive region at the back of the retina, itself located in the middle of the eyeball, responsible for high-definition sight. The common cause of blindness, macular degeneration, refers to this small tissue.
Elena also needed a new cornea, and the sclera—the white of the eyeball. Professor Reibaldi resolved to salvage those from the left eye and transplant them all to the right eye, in which the ocular nerve was preserved through the crash.
“This procedure represents a new frontier in ocular surgery,” said Reibaldi, who practices at the Molinette Hospital in Turn’s City of Health and Science. “Before today, such a contemporaneous transplant of the anterior eye tissue had occurred just once before, while the central retina has never been possible.”
“Now we will wait and see how well the transplanted retina functions, though early signs are encouraging.”
Follow-ups have confirmed that the tissues have reattached correctly, and that Elena is regaining sight in her right eye.
Reibaldi praised the extraordinary collaboration within the team which carried out the procedure, before adding that the biggest prize for them was “the incredible moment in which Elena, opening her eyes, could finally recognize her son and faithful companion in life, Joe the dog.”
In another surgical first, an Arkansas man has at least hope of restored vision, after the first whole-eye transplant.
In a 21-hour procedure, 140 surgeons and attendants completed the transplant on a military veteran who had suffered a near-fatal electrocution.
The surgery, which replaced the better part of his entire face, and connected a donor eyeball to the optic nerves, was declared a success. And though it isn’t clear whether the patient will be able to see out of his eye again, it has meant an enormous step forward for transplantation science and incredible peace of mind for his family.
Aaron James was working on a powerline in Mississippi when he accidentally touched a live wire and received a 7,200-volt shock in June 2021. His wife was called at their home in Arkansas and was told only that her husband wouldn’t be dead by the time she reached the hospital where he was admitted.
James remembers only getting up to go to work, and then waking up days later in a Dallas hospital burn ward where he was flown. He felt okay, he told CNN, so he knew he was going to be okay, but he was missing his face, and taking a selfie allowed him to see inside his own skull.
Dr. Eduardo Rodriguez, director of the Face Transplant Program at NYU Langone Health was briefed about James’ case, and after hearing that he was going to require his left eye amputated, told the surgeons to leave as much of the optic nerve intact for a possible transplant.
He remembers talking to Rodriquez and hearing that he may never see out of the donor eyeball.
“But I said ‘even if it don’t work, I’ll have an eye, and it will be at least normal-looking, and then you all could learn something off of this,’” James told CNN. “You have to have a patient zero.”
After donor tissue was acquired, James was treated at NYU Langone Health in two separate theaters. For the eye transplant, stem cells were injected into the optic nerve and the area around it in hopes of gradual restoration of communication between the brain and the eye.
Over time, the donor tissue gradually took and mended, and a much more human visage appeared in the mirror. Beard stubble began to grow through the skin, and Meagan, Aaron’s wife of 20 years, said it was a bag of emotions.
“It was a crazy, great, weird, strange, ecstatic, happy feeling,” Meagan said. “I was just happy he made it through, and everything was good in the moment.”
