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Br J Ophthalmol 2009;93:1134-1140 doi:10.1136/bjo.2008.155267
  • Review

Impediments to eye transplantation: ocular viability following optic-nerve transection or enucleation

  1. D Ellenberg1,
  2. J Shi1,
  3. S Jain1,
  4. J-H Chang1,
  5. H Ripps1,
  6. S Brady2,
  7. E R Melhem3,
  8. F Lakkis4,
  9. A Adamis1,5,
  10. D-F Chen6,
  11. R Ellis-Behnke7,
  12. R S Langer8,
  13. S M Strittmatter9,
  14. D T Azar1
  1. 1
    Department of Ophthalmology and Visual Sciences, University of Illinois at Chicago, Chicago, Illinois, USA
  2. 2
    Department of Anatomy & Cell Biology, University of Illinois at Chicago, Chicago, Illinois, USA
  3. 3
    Department of Neuroradiology, University of Pennsylvania, Philadelphia, Pennsylvania, USA
  4. 4
    Department of Surgery and Immunology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
  5. 5
    Jerini Ophthalmic, New York, USA
  6. 6
    Schepens Eye Research Institute, Harvard Medical School, Boston, Massachusetts, USA
  7. 7
    Department of Brain and Cognitive Sciences, Massachusetts Institute of Technology, Cambridge, Massachusetts, USA
  8. 8
    Department of Chemical Engineering, Massachusetts Institute of Technology, Cambridge, Massachusetts, USA
  9. 9
    Department of Neurology, Yale University School of Medicine, New Haven, Connecticut, USA
  1. Correspondence to Dr D T Azar, Department of Ophthalmology and Visual Sciences, University of Illinois at Chicago, 1855 W. Taylor Street, Chicago, IL 60612, USA; dazar{at}uic.edu
  • Accepted 21 February 2009
  • Published Online First 13 March 2009

Abstract

Maintenance of ocular viability is one of the major impediments to successful whole-eye transplantation. This review provides a comprehensive understanding of the current literature to help guide future studies in order to overcome this hurdle. A systematic multistage review of published literature was performed. Three specific questions were addressed: (1) Is recovery of visual function following eye transplantation greater in cold-blooded vertebrates when compared with mammals? (2) Is outer retina function following enucleation and reperfusion improved compared with enucleation alone? (3) Following optic-nerve transection, is there a correlation between retinal ganglion cell (RGC) survival and either time after transection or proximity of the transection to the globe? In a majority of the studies performed in the literature, recovery of visual function can occur after whole-eye transplantation in cold-blooded vertebrates. Following enucleation (and reperfusion), outer retinal function is maintained from 4 to 9 h. RGC survival following optic-nerve transection is inversely related to both the time since transection and the proximity of transection to the globe. Lastly, neurotrophins can increase RGC survival following optic-nerve transection. This review of the literature suggests that the use of a donor eye is feasible for whole-eye transplantation.

Footnotes

  • Competing interests None.

  • Funding Supported by: NIH P30-001792 (DTA) and an unrestricted departmental support from Research to Prevent Blindness (New York).

  • Provenance and Peer review Not commissioned; externally peer reviewed.

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