Histopathological findings of anterior lens capsule in paediatric cataract patients

Abstract

AbstractPurpose: To investigate the histopathological findings of the anterior lens capsule in patients with paediatric cataracts.Methods: This study is a prospective interventional study. Anterior capsule tissue samples which were obtained by anterior capsulotomy method during phaco surgery were fixed in 0.1 M phosphate buffered 2.5% glutaraldehyde at +4°C for 2–4 h and after passing through other stages, thin sections were taken and stained. It was then examined and visualized under HITACHI HT7800 transmission electron microscope.Results: Twenty‐three eyes of 19 patients were included. Three patients had unilateral cataract and remaining 16 had bilateral cataract. Four patients had concomitant systemic disease including hydrocephalus, cerebral palsy, juvenile myelomonocytic leukaemia and Down syndrome. Except for one patient, common findings were single‐layered epithelium under the capsule, degenerated organelles with round‐oval and prismatic‐oval nuclei in some regions, enlarged mitochondria and heterochromatin cells. In the case with cerebral palsy, unlike the normal lens structure, collagen fibrils of the connective tissue and fibroblast‐like cells were observed in the epithelial area that should be located under the capsule, in both eyes. Disorganized distribution of collagen fibrils and vacuole structures in the cytoplasm of fibroblast‐like cells were observed.Conclusions: Similar histopathological findings were found in paediatric cataracts with or without systemic disease. Due to the presence of increased inflammation and gliosis in cerebral palsy, the absence of lens epithelium may have developed as a result of degeneration in this patient. The absence of lens epithelium and inflammation are thought to play a role in the development of dense subcapsular fibrosis.