Abstract
Background and objectives: The aim of this study was to examine via electron microscopy the lens epithelial cells in age-related cataracts and compare the findings between patients with and without exfoliation syndrome, in the Greek population. Materials and Methods: Twenty-one patients with age-related cataracts, older than 60 years, were included in the study. Eleven of them also suffered from exfoliation syndrome. Anterior lens capsules, obtained during phacoemulsification, were examined with a transmission electron microscope. Results: In all cases, ultrastructural features of diffuse intracellular and extracellular oedema were noticed to a varying degree and transparent vacuoles were detected. Often, there was more than one layer of cells, giving the impression that healthier cells tried to cover neighboring cells presenting extensive damage. Commonly, cells lost their regular shape and appeared with expanded nuclei carrying dense granules. Apoptotic cells were also detected. The epithelial cells frequently were completely destroyed or absent, exhibiting loose connections amongst them or with the basement membrane. In exfoliation syndrome (XFS) patients the alterations were more severe. Additionally, the lens epithelial cells (LECs) apical cell membrane appeared with varying distances from the basement membrane, due to different cell “heights”, creating an irregular margin of the epithelium (p < 0.05). Conclusion: Transmission electron microscope (TEM) examination revealed ultrastructural abnormalities in all patients’ lens epithelia, more extended and more frequently observed in XFS group. In all cases, the lesions were comparable to those described in severe pathologies, all of which were excluded from the study. Environmental factors such as increased ultraviolet B (UVB) radiation exposure in Mediterranean countries, genetic factors, epigenetic factors, or all of them, could contribute to these alterations. Further epidemiological and molecular biology research is needed, so as to justify these results.
Highlights
Ageing is the most common cause of cataract, but other various risk factors may be implicated in its etiopathogenesis, such as genetic, traumatic, metabolic, toxic agents or radiation
Any factor having an impact on transport processes or morphology of the lens epithelial cells (LECs) may disturb lens transparency [3,4]
We recently studied anterior lens capsules, composed of the lens epithelium and the basement membrane, from patients with senile cataracts and exfoliation syndrome (XFS) via Transmission electron microscope (TEM), for the first time in Greek or Mediterranean populations
Summary
Ageing is the most common cause of cataract, but other various risk factors may be implicated in its etiopathogenesis, such as genetic, traumatic, metabolic, toxic agents or radiation. The epithelium is the most active compartment of the ocular lens. It regulates the ion concentration and water accumulation, protecting the lens inside. Any factor having an impact on transport processes or morphology of the lens epithelial cells (LECs) may disturb lens transparency [3,4]. The aim of this study was to examine via electron microscopy the lens epithelial cells in age-related cataracts and compare the findings between patients with and without exfoliation syndrome, in the Greek population.
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