A novel device called the Eye-in-a-Care-Box (ECaBox) is showing promising results in keeping eyes from deceased donors viable through a perfusion technique that supplies oxygen and nutrients. Experiments on human eyes have shown that retinas remain intact and the ability to respond to light is preserved, paving the way for future whole-eye transplants.
The challenge of whole-eye transplantation
Transplanting a complete eye is extremely complex, not only because of the surgical difficulty but also because eyes begin to degenerate quickly once removed from the body. A previous attempt a few years ago did not restore sight to the transplanted eye. However, researchers led by Dr. Pia Cosma at the Centre for Genomic Regulation in Spain have developed the ECaBox, a device that could change the prospects for this procedure.
Sponsored Protocol
How the ECaBox works: perfusion and revival
The ECaBox uses perfusion, a technique already employed for other organs, delivering an oxygen-rich fluid through the artery that normally supplies the eye. The eye rests on a special bed while excess fluids are drained. The container is sealed to maintain optimal temperature and pressure, and a transparent window allows real-time observation and imaging. According to Shannon Tessier of Massachusetts General Hospital, an expert in organ perfusion, this technology could be a new frontier for retina preservation.
Tests on pig and human eyes: remarkable results
Initial experiments were conducted on pig eyes, which are anatomically similar to human eyes. Eyes kept at room temperature or refrigerated at 4°C degenerated within 24 hours, with cells shrinking and losing structure. In contrast, eyes treated with the ECaBox showed significantly higher viability after 24 hours. Moreover, they were able to respond to light, suggesting they could potentially see if transplanted. The photoreceptive ability, lost immediately after removal, returned after about 15 minutes of perfusion and lasted for over 10 hours in some cases. Later, the team tested the device on 12 eyes from six deceased human donors. One eye from each pair was placed in the ECaBox, the other not. Results confirmed that perfused eyes maintained better retinal preservation.
Sponsored Protocol
Future prospects for eye transplants
The researchers hope the ECaBox will offer a new way to study eye treatments without live animal experiments. With further improvements, it could become a tool to maintain and revive donated eyes for whole-eye transplantation. Whole-eye transplants have been attempted before, such as in 2023 at NYU Langone, where an eye was transplanted along with part of a face. Unfortunately, that eye did not regain sight. To determine whether ECaBox-treated eyes could perform better, actual transplants need to be performed. Meanwhile, the team is developing a portable version to minimize degradation of eyes from beating-heart donors. For insights on digital innovations in healthcare, read our article on Medical Practice Management Software. For broader context on perfusion technology, see the Wikipedia entry on perfusion.
Sponsored Protocol
