Ultrastructural Findings Of The Anterior Lens Capsule In
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Ultrastructural Findings Of The Anterior Lens Capsule In A Case Of Adult Anterior Polar Cataract Achyut Mukherjee 1, Saeed Akhtar 2, Amit Patel 1, Vinod Kumar 1 1: University Hospital of Wales, Cardiff, United Kingdom. 2: Department of Optometry and Vision Sciences, Cardiff University The authors have no financial interest.
Methods n An adult patient with clinical anterior polar cataract underwent routine phakoemulsification cataract surgery n The anterior capsule was removed intraoperatively by continuous curvilinear capsulorrhexis, and this specimen was subjected to ultrastructural examination
Methods n n n The lens epithelium and basement membrane was fixed in 2. 5% glutaraldehyde in 0. 1 M molar phosphate buffer at 4 C for 4 hours The tissue was subsequently washed with 0. 1 M molar phosphate buffer and dehydrated with series of graded ethanol. The tissue was then fixed and embedded in spurrs resin. Ultrathin sections were stained with uranyle acetate and lead citrate The prepared sample was studied using transmission electron microscopy
Light microscopic findings L L B B E E Light microscopy B: basement membrane (capsule), E: epithelium L: sub-epithelial material of the pathological lens
Ultrastructural findings - lens epithelial cells E V L E: Epithelium n n B: Basement membrane V: Vacuole Ultrastructural studies showed lens epithelial cells that were severely damaged. The cells showed electron lucent vacuolation and disruption.
Ultrastructural findings - lens epithelial cell nucleus n Epithelial cell nuclei appeared degenerate
Conclusion n Previous histological studies of anterior polar cataract have describes fibrous metaplasia as being present n Lens epithelial hyperplasia and subepithelial lens fiber necrosis has also been suggested as a pathological finding n In this case, there was some evidence of hyperplastic changes, although no fibrous metaplasia was present.
Conclusion n The role of epithelial cell dysfunction in anterior polar catarct remains uncertain. n Past series of flat anterior polar cataract have shown relatively normal cuboidal epithelial cells. n In our case, however, the changes were marked degenerative alterations at an ultrastructural level. n This difference may partly relate to the duration of pathology: most histological series are in children, while this was an adult patient. n In the case of pyramidal anterior polar cataract, degenerate and absent epithelium have been reported, similar to our findings in this case.
References 1. Font RL, Brownstein S. A light and electron microscopic study of anterior subcapsular cataracts. Am J Ophthalmol 1974; 78: 972 -84. 2. Henkind P, Prose P. Anterior polar cataract. Electron-microscopic evidence of collagen. Am J Ophthalmol 1967; 63: 768 -71. 3. Wheeler DT, Mullaney PB, Awad A, Zwaan J. Pyramidal anterior polar cataracts. Ophthalmology 1999; 106: 2362 -7. 4. Amaya L, Taylor D, Russell-Eggitt I, Nischal KK, Lengyel D. The morphology and natural history of childhood cataracts. Surv Ophthalmol 2003; 48: 125 -44. 5. Dilley KJ, Bron AJ, Habgood JO. Anterior polar and posterior subcapsular cataract in a patient with retinitis pigmentosa: a light-microscopic and ultrastructural study. Exp Eye Res 1976; 22: 155 -67.
