Attention to the Eye is Crucial for Face Transplantation

Facial transplantation has the potential to enhance a patient's quality of life after severe facial trauma. But making sure that the transplantation is a success is an important part. Now, scientists have found that a lack of attention to eyelid function and vision can leave patients with impaired vision, corneal exposure, eyelid traction and other eyelid-related complications.

"There is no guarantee that the eyelids will function normally after transplantation," said Eduardo Rodriguez, one of the researchers, in a news release. "Careful and methodical preparation prior to facial transplantation, and attentiveness to post-surgical eyelid function, is essential to preserving vision in these case."

The scientists actually reported on a patient with a severe injury to the central and lower face caused by a gunshot injury. More specifically, they described the procedures they used to preserve and restore blinking function, which can be damaged from the trauma and during surgery. In addition, nerve injury can also occur.

In the case of the patient, named Richard Lee Norris, a total face, double jaw, and tongue transplantation was administered. The researchers also conducted slow-motion video analysis of blinking before face transplantation and up to several months after the surgery.

"This is the first article addressing blinking in the facial transplant setting," said Rodriguez. "We have to work carefully to preserve the underlying muscle, the eyelids structures and their innervation. Blinking may seem like a simple, automatic function to many people. However, if you can't blink, your corneas are susceptible to the extremes of weather and exposure of the corneas while you sleep due to incomplete closure. This ultimately results in painful corneal exposure and potential scarring over part of the pupil which will ultimately impair vision."

The findings are published in the journal Plastic and Reconstructive Surgery.

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