An eye for an eye

Within two decades, US surgeon Kia Washington hopes to see the first full eye transplant performed

18 Jan 2017 by Olivia Wannan

Eye transplantUniversity of Pittsburgh plastic surgery assistant professor, Kia Washington, has transplanted the eyes of rats to prepare for the procedure to eventually be done in humans. She spoke with OT about her research.

When might surgeons be able to accomplish the feat of an eye transplant, by your estimates?

I think that it will likely happen in the next 10–20 years.

What in particular limits surgeons from performing such a procedure now?

I believe we have the surgical innovation to perform the procedure currently. A key challenge is coaxing the optic nerve to regenerate.

What have you been able to achieve with animals, thus far?

We have developed a [study] in rats for whole eye transplantation. We are able to surgically transplant the entire eye with the optic nerve and keep the eye viable with blood flow. We are now working to try to achieve functional [outcomes].

What have your animal procedures taught you, and how would these compare to the same surgery on a human?

The animal procedures in our [previous studies] are very different from what the procedures will be in humans. However, from the animals so far, we have learned that the eye can remain viable after transplantation with normal aqueous humour dynamics.

Beyond surgical techniques, what else is needed to accomplish an eye transplant?

The ability to restore functional vision with optic nerve regeneration and [brain] remodelling. We also need to learn more about immunosuppression in the setting of eye transplantation.

When surgeons can accomplish this, what type of patient would it be suitable for?

I think the ideal first patient would be a blind face transplant candidate, someone who has undergone facial and ocular trauma. The eye could be transplanted along with the face.

What inspires or drives you to achieve this?

It’s a ‘moonshot’ – high risk and high reward. It is really exciting. No one has really looked into it in the depth that we have. Therefore, every day we are learning something new.

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