37. Longitudinal Outcomes From The World’s First Combined Face and Whole-Eye Transplantation

PURPOSE: Recent literature has demonstrated the potential of whole-eye transplantation (WET) within face transplantation. This abstract depicts an one-year follow-up of our recent face and whole-eye transplant (FWET) recipient and reviews our steadfast craniofacial and ophthalmologic outcomes. METHODS: The superficial temporal artery (STA), and the superficial temporal vein (STV), were anastomosed to maintain vascular flow to the globe via the external system. A freed STA/STV was rotated into the retro-orbital space and an end-to-end microvascular anastomosis to the ophthalmic artery and ophthalmic vein, respectively, were performed to minimize ischemic time to the globe. Furthermore, patient specific cutting guides were fabricated allowing for accurate harvest of the “box osteotomy” without compromise to the periorbital musculature and soft tissue. RESULTS: Qualitative comparison between preoperative donor fluorescein angiography with postoperative recipient fluorescein angiography and indocyanine green analysis demonstrate robust perfusion to the retina and choroid, respectively. These results have remained steadfast throughout the patient’s postoperative course. Additionally, one year post-surgical accuracy was found to be 89%. Finally, the patient has been rejection free throughout his postoperative course on our novel immunosuppressive protocol. CONCLUSION: Employing innovative microvascular anastomotic bypass techniques and precision-oriented surgical guides, we have successfully minimized ischemic intervals, safeguarding retinal viability during transplantation. The one-year postoperative perfusion outcomes, paired with a surgical precision of 89%, herald a new frontier in reconstructive surgery. These advancements not only bolster the anatomical feasibility of such complex procedures but also offer a beacon of hope for restoring vision and facial integrity in patients with severe disfigurements.