Three years ago, Aaron James, a utility lineman, lost half of his face and his arm when he was struck by a high-voltage electrical cable. Last year, the 47-year-old received a face and whole-eye transplant – the first of its kind. The surgery took 21 hours and involved 140 healthcare professionals.

James is making remarkable progress, as recently reported in Jama , a medical journal. Although he cannot see out of the transplanted eye, it continues to maintain normal pressure and blood flow – and it hasn’t shrunk (something that happened when eye transplants were previously attempted in animals). Doctors said the surgery laid the “foundation for further advancements and ongoing research”.

While face transplants have been done previously, they have only a relatively recent entry into surgical history, with the first partial transplant occurring in 2005 and the first full transplant in 2010 . As of September 2023, 50 of these surgeries have been undertaken , globally. Tens of thousands of corneal transplants – partial eye transplants – are done every year.

But this is a much more straightforward operation. Eyes are difficult to transplant For a start, eyes are held in place by many strap-like muscles that help to move the eye around, and myriad small blood vessels keep the muscles and tissues of the eye alive. There is also a second far more complex reason eyes are difficult to transplant: the optic nerve.

The optic nerve carries electrical information to the visua.