Researchers in Spain say they have built a machine that can keep recently removed eyes alive enough to preserve retinal structure and light responses, a small but useful step toward a procedure surgeons still cannot make work: transplanting a whole eye that can see.
Pia Cosma at the Centre for Genomic Regulation at the Barcelona Institute of Science and Technology and colleagues described the system in a bioRxiv preprint. The paper has not been peer reviewed, and Cosma’s team did not comment on the work.
The device, called the Eye-in-a-Care-Box, or ECaBox, uses perfusion. That means it pushes an oxygen-rich fluid through the artery that normally feeds the eye with blood. The removed eye rests inside the sealed box on a support bed, while extra fluid drains away. The enclosure controls temperature and pressure, and a transparent side window lets researchers image and inspect the organ while it is being maintained.
That plumbing detail is the point. An eye outside the body is not just a glassy marble waiting for a surgeon. Its cells begin deteriorating after removal, and the retina is especially demanding. If the tissue collapses before a transplant, reconnecting it later is mostly theater.
Cosma’s group first tested pig eyes, which are easier to obtain and anatomically similar to human eyes. The team got the organs from a local slaughterhouse. Pig eyes left at room temperature deteriorated quickly, according to the preprint: cells shrank and the eye structure degraded. Cooling the eyes to 4 °C, or 39 °F, did not solve the problem; the organs still deteriorated within 24 hours.
Eyes placed in the ECaBox looked better after the same period. The researchers reported that perfused pig eyes were significantly more viable than untreated controls after 24 hours.
The more provocative claim is functional. Untreated pig eyes lost light responsiveness immediately after removal, according to Cosma and colleagues. After about 15 minutes in the perfusion device, that response returned. Some treated eyes continued responding for 10 hours or longer. That does not mean the eyes could produce vision in a person. It means the tissue showed electrical activity consistent with a retina that had not given up yet.
The team then moved to human donor eyes. It collected 12 eyes from six deceased people. In each pair, one eye went into the ECaBox and the other did not. The perfused human eyes were better preserved, and their retinas remained intact, according to the preprint.
Shannon Tessier, a Massachusetts General Hospital researcher who studies perfusion in other organs and was not involved in the work, called the approach “really cool” and told MIT Technology Review it could open a new area for retina preservation. She also said researchers will not know whether ECaBox-treated eyes can perform better in transplant until such eyes are actually transplanted.
That caveat is doing a lot of work. Whole-eye transplantation has a long record of limited success, mostly in animal research. In May 2023, surgeons at NYU Langone transplanted a whole eye as part of a partial face transplant for a man injured in a high-voltage electrical accident. NYU Langone later said the patient recovered well, but he could not see through the transplanted eye.
Cosma and colleagues say the device may first serve a less cinematic purpose: studying eye disease and treatments without relying on experiments in living animals. They also write that they plan to build a portable operating-room version of the ECaBox to reduce degradation in eyes from heart-beating donors when such organs become available.
This story draws on original reporting from MIT Technology Review.
