Morphological assessment of lens capsule after different techniques of cataract extraction

Abstract

to evaluate morphological changes in the posterior lens capsule (LC) after different techniques of cataract extraction. Eight pseudophakic human autopsy eyes were divided into two groups by the technique used for cataract extraction. Group 1 included 4 eyes following extracapsular cataract extraction (ECCE) and rigid IOL implantation. Group 2 included 4 eyes after minimally invasive cataract surgery (MICS) that involves the use of ultrasound energy. Semithin LC sections were polychromatically stained, visually examined, and imaged for further analysis. There were certain common features in clinical and morphological appearances of lens capsules from either group, including fibrous metaplasia of epithelial cells and/or pseudoregenerative Elschnig-Adamuk pearls on their inner surfaces, more significant in the ECCE group. MICS group, however, demonstrated many distinct and previously undescribed changes. In particular, post-MICS LCs looked swollen, flabby, and even amorphous, their architectonics were disturbed and fibers separated forming micro slit-like spaces, which could be a result of acoustic cavitation caused by ultrasound exposure. We have named this morphological type of secondary cataract «hyaloid-like». Clinical and morphological type of postoperative LC opacification as well as its severity depends, to a certain extent, on the technique used for cataract extraction. Hyaloid-like opacifications are typical of minimally invasive surgery involving the use of ultrasound and often show no 'classic' changes (fibroproliferative and pseudoregenerative). The latter is explained by the fact that the posterior LC, which has lost its biomechanical properties, can no longer be a substrate for proliferating cells.