全眼球移植（Whole eye transplantation, WET）是治疗因外伤、肿瘤等导致眼球不可逆损伤及永久性失明的潜在终极手段。其核心不仅在于实现眼球解剖结构的完整移植，更关键的是实现功能性视觉恢复，关键挑战包括优化手术策略重建眼球血液循环，实现供体视神经与受体视觉中枢的神经连接，建立精准有效的免疫调控策略以平衡移植耐受与感染风险。本文系统梳理了WET领域的研究进展与发展挑战。早期研究以变温动物模型为主，这些模型在一定程度上证实了视觉通路在眼球移植后仍具有一定的可塑性，但由于其眼球结构与人类存在显著解剖差异，且实验设计中未涉及精细的血管与神经吻合，因而临床转化价值有限。随着显微血管技术的发展，哺乳动物模型及人眼球移植的初步探索在显微外科血管吻合技术方面取得重要突破，实现了移植眼球视网膜血液灌注的短期重建，但仍面临视神经再生障碍和功能维持难题。当前的研究瓶颈主要集中在三个方面：血液循环重建技术优化、神经轴突精准再生及免疫微环境调控。建立与人类接近的标准化非人灵长类动物模型，并开展系统性的实验研究，将为克服现有技术障碍、推动WET走向临床提供至关重要的实验依据和新思路。

Whole eye transplantation (WET) is a potential definitive treatment for irreversible ocular damage and permanent blindness caused by conditions like trauma or tumors. The success of WET depends not only on the complete anatomical restoration of the transplanted eye but, more critically, on the recovery of functional vision. Key challenges in this field include optimizing surgical strategies to re-establish ocular blood circulation, achieving functional neural integration between the donor optic nerve and the recipient's visual centers, and developing precise and effective immunomodulation strategies to strike a balance transplant tolerance and infection risk. This review provides a systematic review of the research progress and developmental challenges in the field of WET. Early studies primarily utilized poikilothermic animal models, which demonstrated a certain degree of plasticity in the visual pathway following transplantation. However, due to significant anatomical differences compared to humans and the lack of sophisticated vascular and neural anastomosis in experimental designs, their clinical translatability of these studies remained constrained. With the progress in microvascular techniques, preliminary explorations in mammalian models and human eye transplantation have achieved significant breakthroughs in microsurgical vascular anastomosis, enabling the short-term reestablishment of retinal blood perfusion in transplanted eyes. Nonetheless, perisitent obstacles include inadequate optic nerve regeneration and poor long-term functional maintenance. Currently, research bottlenecks mainly focus on three aspects: optimizing surgical techniques for blood circulation reconstruction, precisely regenerating nerve axons, and regulating the immune microenvironment. Establishing standardized non-human primate models that closely mimic humans and conducting systematic experimental studies will furnish crucial evidence and novel insights to overcome existing technical hurdles and propel WET toward clinical application.