Device revives eyeballs from dead donors, paving way for eye transplants

Transplanting a whole human eye is a difficult surgery. The eyes themselves start to degenerate quickly after leaving the body. Previous attempts at the surgery resulted in the newly-transplanted eye being unable to see.

Researchers believe they may have a solution: a device that maintains and revives freshly removed eyeballs using perfusion. This technique provides surgically-removed organs with oxygen and nutrients, similar to when they're inside the body. Treated eyes don't degrade as quickly and appear to retain the ability to transmit electrical signals and potentially see.

Shannon Tessier at Massachusetts General Hospital, who wasn't involved in the research, says, "It's really cool. It could be a new frontier for retina preservation." Pia Cosma at the Centre for Genomic Regulation at the Barcelona Institute of Science and Technology in Spain and her colleagues developed the Eye-in-a-Care-Box (ECaBox). The device delivers an oxygen-rich supply of fluid through the artery that normally supplies the eye with blood.

The eye sits on a "bed," and excess fluids are drained away. A clear window on the side allows researchers to study and image the eye. The team started experimenting with pig eyes, which are anatomically similar to human eyes.

Pig eyes kept at room temperature degenerate quickly. Cooling the organs didn't help preserve them; they degenerated within 24 hours even at 4°C (39°F). However, eyes kept in the ECaBox fared much better.

24 hours later, tests suggested the perfused eyes were "significantly more viable" than untreated eyes. The perfused eyes also seemed to respond to light, suggesting they might see if transplanted. Untreated pig eyes lost this ability quickly, but it returned after 15 minutes of perfusion.

A few treated eyes maintained this ability for 10 hours or more. The team then tested their device on human eyes, collecting 12 eyes from six deceased individuals. In each case, one eye was put in the device, while the other wasn't.

The perfused eyes did better, with their retinas preserved. Cosma and her colleagues hope their device could offer a new way to study eye treatments without experimenting on living animals. They also hope, with improvements, the ECaBox might maintain and revive donated human eyes for whole-eye transplantation.

Whole-eye transplants have been attempted in the past, mostly in research animals, with limited success. In May 2023, a team at NYU Langone transplanted an eye along with part of a face to a man who had lost much of his face, including his left eye, in an electrical accident. Although the man recovered well, he wasn't able to see out of the transplanted eye.