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Impediments to Eye Transplantation: Ocular Viability Following Optic Nerve Transection or Enucleation
  1. David Ellenberg (dyellenberg{at}gmail.com),
  2. Jun Shi (jshi35{at}uic.edu),
  3. Sandeep Jain (jains{at}uic.edu),
  4. Jin-Hong Chang (changr{at}uic.edu),
  5. Scott Brady (stbrady{at}uic.edu),
  6. Elias Melhem (emelhem{at}rad.upenn.edu),
  7. Fadi Lakkis (lakkisf{at}upmc.edu),
  8. Anthony Adamis (tadamis{at}jophth.com),
  9. Dong-Feng Chen (dongfeng.chen{at}schepens.harvard.edu),
  10. Ellis-Behnke Rutledge (rutledg{at}mit.edu),
  11. Robert Langer (rlanger{at}mit.edu),
  12. Stephen Strittmatter (stephen.strittmatter{at}yale.edu),
  13. Dimitri T Azar (dazar{at}uic.edu)
  1. University of Illinois at Chicago, United States
  2. University of Illinois at Chicago, United States
  3. University of Illinois at Chicago, United States
  4. University of Illinois at Chicago, United States
  5. University of Illinois at Chicago, United States
  6. University of Pennsylvania, United States
  7. University of Pittsburgh, United States
  8. Jerini Ophthalmic, United States
  9. Schepens Eye Research Institute, United States
  10. Massachusetts Institute of Technology, United States
  11. Massachusetts Institute of Technology, United States
  12. Yale, United States
  13. University of Illinois at Chicago, United States

    Abstract

    Maintenance of ocular viability is one of the major impediments to successful whole eye transplantation. We provide 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 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 four to nine hours. Retinal ganglion cell (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.

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