Abstract

The higher prevalence of diabetes for cataracts as a component of the multifactorial genesis of age-related cataracts has been proven in several epidemiological studies. Most of these results identified diabetes as a highly significant risk factor for cataracts in older diabetic males and females. The increased cataract risk of diabetics then decreases after the age of 65 years and is related to different types of opacity. In addition to the sorbitol pathway, diabetic hyperglycaemia causes increased formation of glucose-derived advanced glycation cytotoxic end-products. In connection with these specific pathological changes, the crucial role of the lens epithelium with respect to cataractogenesis is emphasised in several studies. The results of our own prospective clinical study proved the significantly lower mean cell density in type II diabetics compared with eyes from non-diabetics. Together with the other determined morphological cell characteristics, this result seems to be due to the cataractogenic influence of diabetic metabolic disorders on the lens There are some indications for the primary cataractogenic importance of the lens epithelium in type II diabetes.

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