Ultrastructure of anterior lens capsule in uveitic cataract

Abstract

Abstract Purpose To evaluate the ultrastructure changes of anterior lens capsule in patients with different forms of uveitis, who underwent cataract surgery at the University Eye Clinic Ljubljana, Slovenia between years 2001 and 2007. Methods Anterior lens capsules were obtained during cataract surgery, fixated and prepared for semi‐thin sections technique and transmission electron microscopy. Results 22 uveitic cataract were studied (idiopathic anterior uveitis‐9, Fuchs‐5, panuveitis‐5, HSV‐1, toxoplasmosis‐1, uveitis in RA‐1). The cataract was mature‐1, cortical‐14, fibrotic‐1 or nuclear‐6. The anterior capsule thickness showed irregularity in and between the cases spanning from 8,8 to 25,2 μm (average 16,33, SD 4,85μm). In 12 samples intrusions of capsule at the capsule‐epithelial border embedding cellular material were found. Capsule itself showed ultrastructure changes in 18 samples, including: filaments, rarefication of capsule or its anterior chamber boarder, and lamellae. In 5 samples the amorphous material at the anterior chamber boarder was seen. Epithelial changes were observed in all 22 samples, including: vacuolisation, multilayered epithelium, detached epithelium, intercellular space, star‐shaped nuclei, necrotic cells, lipofucsin granules. In 4 samples the epithelium was unrecognizable due to extensive fibrosis or necrosis. Conclusion All studied uveitic cataracts showed epithelial and most also capsular changes. Some capsules showed extensive changes with unrecognizable structures. The findings did not correlate to clinical appearance or diagnosis and most probably resulted from nonspecific response to inflammation. Amorphous depositions could be inflammatory debris. Further studies need to be done to explain the underlying processes.