Age-related appearance of lamellar structures in lens capsule of cataractous eyes and its pathological significance

Abstract

Purpose: To determine morphological changes in the lens capsule with aging. Design: Cross-sectional study. Setting: Hayashi Eye Hospital, Fukuoka, Japan. Methods: Twenty-five eyes from the older patient group (aged ≥ 80 years) and 25 eyes from the younger patient group (aged ≤ 65 years) who were diagnosed with cataract and indicated for surgery were included in the study. After continuous curvilinear capsulorhexis (CCC), the anterior lens capsule was collected, immediately fixed, and processed for electron microscopy analysis. Backscattered electron images of the cross-section of the anterior lens capsule were observed under a scanning electron microscope. The ultrastructure of the anterior lens capsule was observed and compared between groups. Factors associated with the occurrence of the lamellar structure were also identified. The presence or absence of a lamellar structure was an objective variable, and preoperative clinical characteristics were the explanatory variables. Results: Fifty eyes of 50 patients were included. In the younger patient group, 20 (80%) eyes had a homogeneous lens capsule, whereas 5 eyes had a lamellar structure. By contrast, in the older patient group, 5 eyes had homogeneous structures, while the remaining 20 (80%) eyes had lamellar structures. One eye showed capsular delamination. The only significant factor for the occurrence of lamellar structures was age group (p<0.01, nominal logistic regression analysis). Conclusions: Lamellar structures appear in the anterior capsule during aging. The appearance of lamellar structures indicates fragility of the lens capsule, which may, in turn, lead to capsular delamination or lens dislocation in some cases.