Restoration of electroretinogram activity in exenterated swine 			 eyes following ophthalmic artery anastomosis

Shi, Jun; Ellenberg, David; Kim, Jae Yong; Qian, Haohua; Ripps, Harris; Jain, Sandeep; Chang, Jin Hong; Azar, Dimitri T.

doi:10.3233/rnn-2009-0485

Cited by 9 publications

(10 citation statements)

References 23 publications

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“…The eyes were perfused under positive pressure with various buffered perfusates. 24–28 The sequencing of our proposed protocol is such that the recipient can be prepared before any ischemia time such that, on availability of the donor tissue, inset, vessel anastomosis, and nerve coaptation can begin immediately. The timings outlined in Tables 3 and 4 would obviously be longer in actual clinical scenarios (e.g., with physiologic bleeding) but nonetheless demonstrate the spectra of this surgery to be within the realm of the achievable.…”

Section: Discussionmentioning

confidence: 99%

Total Human Eye Allotransplantation: Developing Surgical Protocols for Donor and Recipient Procedures

Davidson

Wang

et al. 2016

Plastic &Amp; Reconstructive Surgery

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Background Vascularized composite allotransplantation of the eye is an appealing, novel method for reconstruction of the nonfunctioning eye. The authors’ group has established the first orthotopic model for eye transplantation in the rat. With advancements in immunomodulation strategies together with new therapies in neuroregeneration, parallel development of human surgical protocols is vital for ensuring momentum toward eye transplantation in actual patients. Methods Cadaveric donor tissue harvest (n = 8) was performed with orbital exenteration, combined open craniotomy, and endonasal approach to ligate the ophthalmic artery with a cuff of paraclival internal carotid artery, for transection of the optic nerve at the optic chiasm and transection of cranial nerves III to VI and the superior ophthalmic vein at the cavernous sinus. Candidate recipient vessels (superficial temporal/internal maxillary/facial artery and superficial temporal/facial vein) were exposed. Vein grafts were required for all anastomoses. Donor tissue was secured in recipient orbits followed by sequential venous and arterial anastomoses and nerve coaptation. Pedicle lengths and calibers were measured. All steps were timed, photographed, video recorded, and critically analyzed after each operative session. Results The technical feasibility of cadaveric donor procurement and transplantation to cadaveric recipient was established. Mean measurements included optic nerve length (39 mm) and caliber (5 mm), donor artery length (33 mm) and caliber (3 mm), and superior ophthalmic vein length (15 mm) and caliber (0.5 mm). Recipient superficial temporal, internal maxillary artery, and facial artery calibers were 0.8, 2, and 2 mm, respectively; and superior temporal and facial vein calibers were 0.8 and 2.5 mm, respectively. Conclusion This surgical protocol serves as a benchmark for optimization of technique, large-animal model development, and ultimately potentiating the possibility of vision restoration transplantation surgery.

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Section: Discussionmentioning

confidence: 99%

Total Human Eye Allotransplantation: Developing Surgical Protocols for Donor and Recipient Procedures

Davidson

Wang

et al. 2016

Plastic &Amp; Reconstructive Surgery

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“…Fewer than 5% RGCs remain a month following optic nerve injury. Retinal responses on ERG disappear 5 min after enucleation; however, retinal function may be preserved for up to 4-9 h by ex-vivo reperfusion [16,49]. The RGC loss is most rapid when injuries are made proximally (close to the eye) and is slower after optic nerve crush injury [47,50,51].…”

Section: Inflammation and Optic Nerve Regenerationmentioning

confidence: 99%

Immunological considerations and concerns as pertinent to whole eye transplantation

Zor

Karagöz

Kapucu

et al. 2019

Current Opinion in Organ Transplantation

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Purpose of reviewThe advent of clinical vascularized composite allotransplantation (VCA), offers hope for whole eye transplantation (WET) in patients with devastating vison loss that fails or defies current treatment options. Optic nerve regeneration and reintegration remain the overarching hurdles to WET. However, the realization of WET may indeed be limited by our lack of understanding of the singular immunological features of the eye as pertinent to graft survival and functional vision restoration in the setting of transplantation. Recent findingsLike other VCA, such as the hand or face, the eye includes multiple tissues with distinct embryonic lineage and differential antigenicity. The ultimate goal of vision restoration through WET requires optimal immune modulation of the graft for successful optic nerve regeneration. Our team is exploring barriers to our understanding of the immunology of the eye in the context of WET including the role of immune privilege and lymphatic drainage on rejection, as well as the effects ischemia, reperfusion injury and rejection on optic nerve regeneration.

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“…Sher 20 did not evaluate retinal function in these experiments. Shi et al 21 exenterated swine eyes and anastomosed the ophthalmic artery to the carotid artery. Slit lamp examination revealed no abnormalities in the exenterated eyes.…”

Section: Mammalian Modelsmentioning

confidence: 99%

“…Restoration of reperfusion was confirmed with histology by the presence of FITC lectin-stained retinal vessels imaged with confocal microscopy. 21…”

Section: Mammalian Modelsmentioning

confidence: 99%

Whole-eye transplantation: a look into the past and vision for the future

Bourne

Komatsu

et al. 2016

Eye

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Blindness afflicts ~39 million people worldwide. Retinal ganglion cells are unable to regenerate, making this condition irreversible in many cases. Whole-eye transplantation (WET) provides the opportunity to replace diseased retinal ganglion cells, as well as the entire optical system and surrounding facial tissue, if necessary. Recent success in face transplantation demonstrates that this may be a promising treatment for what has been to this time an incurable condition. An animal model for WET must be established to further enhance our knowledge of nerve regeneration, immunosuppression, and technical aspects of surgery. A systematic review of the literature was performed to evaluate studies describing animal models for WET. Only articles in which the eye was completely enucleated and reimplanted were included. Study methods and results were compared. In the majority of published literature, WET can result in recovery of vision in cold-blooded vertebrates. There are a few instances in which mammalian WET models demonstrate survival of the transplanted tissue following neurovascular anastomosis and the ability to maintain brief electroretinogram activity in the new host. In this study we review in cold-blooded vertebrates and mammalian animal models for WET and discuss prospects for future research for translation to human eye transplantation.

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Restoration of electroretinogram activity in exenterated swine eyes following ophthalmic artery anastomosis

Cited by 9 publications

References 23 publications

Total Human Eye Allotransplantation: Developing Surgical Protocols for Donor and Recipient Procedures

Total Human Eye Allotransplantation: Developing Surgical Protocols for Donor and Recipient Procedures

Immunological considerations and concerns as pertinent to whole eye transplantation

Whole-eye transplantation: a look into the past and vision for the future

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