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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