In May of 2023, Aaron James, an electrical lineman, had the first partial face transplant to include an eye. A year after the procedure, there haven’t been signs of rejection, and there is blood flow to the donated eye. But James cannot see out of the eye, a medical team from New York University Langone Health reported September 9 in the Journal of the American Medical Association. The nerve connections from the eye have withered.

A test that assesses the eye’s ability to react to light detected a small response, although this result does not mean sight will return, the medical team notes. James doesn’t have sensation in the eye’s surface and the eye’s lid remains closed. He will be on immunosuppression drugs for the rest of his life.

Whole eye transplant has been long proposed as a potential solution for blindness, but experts note there are many barriers to attempting to restore sight this way. A big one is renewing nerve connections from retinal cells to visual processing centers in the brain. These connections do not regenerate after injury.

James suffered a high-voltage electrical injury in 2021 that destroyed his left eye, nose, lips and a large amount of facial tissue. An appropriate deceased donor was identified in May of 2023. The transplantation surgery took 21 hours. James reported significant improvements in his quality of life at the one-year mark.