Man who underwent world’s first eye and face transplant says it changed his life

Aaron James can’t stop looking at himself in the mirror.

The 47-year-old U.S. Army veteran and electrical installer was seriously injured in a work accident in June 2021 that left his left eye, chin, nose, mouth and left arm shattered, and much of his face severely damaged by electrical burns.

For a long time afterward, the Hot Springs, Ark., man said he didn’t feel like himself. He couldn’t smell or taste anything. And everywhere he went, people stared.

But now, a year after he underwent what his medical team says was the world’s first full-eye and partial-face transplant, he is finally starting to get used to the face that greets him in the mirror.

“I see myself,” James said. As it happens host Nil Köksal. “That’s why I look at myself so often, because it’s still stunning to me.”

James is blind in his new eye, but his doctors say the fact that the eye appears healthy and well-integrated a year later is a huge scientific success and brings them one step closer to restoring his sight through a transplant.

Face transplants are rare, and James’s whole eye transplant was the first in the world, according to his medical team at NYU Langone Health in New York, which described his progress in the medical journal JAMA.

“We don’t know if it will work”

James says he was already scheduled for facial surgery when his medical team approached him about integrating an experimental eye transplant. Both the face and the eye came from the same donor.

He underwent a 21-hour procedure in May 2023, a feat made possible by the collaboration of over 140 medical specialists.

He knew it was risky, he says, and that it might not work. His body might reject the new eye. And there was — and still is — no guarantee he would ever regain his lost vision.

But he also knew that no matter what happened, the data his medical team collected would prove invaluable to others in a similar situation, he added.

According to an editorial in JAMA, there are more than 40 million people worldwide who are blind in both eyes, sometimes due to disease and sometimes due to injury. And there is currently no way to restore lost vision.

James’s operation is a step towards changing this situation.

“They told me from the beginning, you know, this has never been done. We don’t know if it will work,” he said. “But I trusted them.”

Besides, James figured he had nothing to lose and everything to gain.

“I will be taking immunosuppressive drugs for the rest of my life” [and] I didn’t pay attention to it at first.

Why is it so difficult to replace an eye?

Doctors have long been exploring the possibility of treating vision through eye transplantation, but integrating this organ is extremely difficult due to its complex interactions with the brain.

The study authors reported that animal tests so far have shown that the transplanted eyes were rejected by the recipients and began to shrink and deteriorate over time.

But for James, that hasn’t happened yet.

“Aaron can’t see the light when we shine it in his eye, but when you look at the eye itself, it’s really amazing,” said Dr. Vaidehi Dedania, an ophthalmologist at NYU Grossman School of Medicine who monitored James’ recovery and co-authored the study.

“It’s nice and round, so it’s not wrinkled or shriveled at all. And that tells us that the eye is getting enough blood to make its own fluid, just like our body can make blood from bone marrow. And that’s how the eye maintains itself.”

Although the eye did not regain vision, tests showed that the retina responded electrically to light, indicating that the rods, codas, and photosensitive nerve cells survived the surgery intact.

That fact offers hope for vision restoration with future transplants, said Dr. Eduardo D. Rodriguez, senior author of the study and chief surgeon at James Hospital.

“We are truly amazed at Aaron’s recovery; he has not experienced any episodes of rejection,” NYU said in a press release.

He praised the team’s “methodical approach to the donor selection process, which ensured Aaron received the best possible donor” and their unique and rigorous immunosuppressive treatment regimen.

“Our findings over the past year represent promising initial results, laying the foundation for further advances and ongoing research.”

Dr. Bohdan Pomahač, a Yale School of Medicine surgeon who performed the first full face transplant in the U.S. in 2011, called it a “technically brilliant operation.”

“The authors have pushed the boundaries of innovation,” said Pomahač, who was not involved in Jame’s case. said Nature.

The key to restoring vision is finding a way to recreate the optic nerve, which carries light signals from the retina to the brain’s vision center, the authors say.

“You take it one step at a time,” Dedania said. “This at least gives us some runway now that we can work with to get to the next step.”

Eating is a pleasure again

The surgery has had a dramatic impact on James’ life. The face transplant has not only changed the way he sees himself and is seen by others, but it has also given him back his sense of taste and smell.

He says he can’t remember whether the first food he fully enjoyed after surgery was applesauce or chocolate pudding. “I just remember it was really good,” he said.

He said his wife and daughter welcomed his recovery, but said accidents like his have a domino effect on the lives of victims’ loved ones.

“When my accident happened, our daughter was 16, and you know, 16-year-olds have enough problems trying to grow up. [and] “throw that in there,” he said. “But she’s handled it well. She’s strong. She graduated from high school [and is] “I’m going to college now.”

But aside from the personal consequences of the procedure, James says he is proud to be a part of medical history.

“Everybody wants to do their part, you know, to help,” he said. “Maybe that’s my role.”