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Changes in the lens epithelium with respect to cataractogenesis—light microscopic and Scheimpflug densitometric analysis of the cataractous and the clear lens of diabetics and non-diabetics

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Abstract

Background

We compared the human lens documented, using the Scheimpflug densitometry, with the light microscopic changes in the epithelium of the anterior central lens in patients with age-related cataract and diabetes mellitus type II and verified the findings on the control tissue of the clear eye lens. We wanted to determine the relevance of the lens epithelium in cataract formation in type II diabetics compared to non-diabetics.

Materials and methods

One hundred fifty central lens capsules (138 cataract and 12 clear lenses) of type II diabetics (n=77, 45 female, 32 male) and non-diabetics (n=73, 41 female, 32 male) were examined by light microscope, regarding defined histomorphological parameters. Further criteria were duration of diabetes, diabetic retinopathy, cataract (PENTACAM, scheimpflug densitometric definition), protein content in the aqueous humour (laser flare meter 500 KOWA, tyndallometry), different blood parameters and glucose content in the aqueous humour.

Results

The mean cell density in the cataractous lens in type II diabetics was 3,951±528 cells/mm2 and in non-diabetics 4,329±580 cells/mm2 (P<0.001); in the clear lens it corresponded to 4,593±409 cells/mm2 (type II diabetics) and 4,894±333 cells/mm2 (non-diabetics, P=0.207). The cell density of the cataractous lens in type II diabetics (P=0.005) and in non-diabetics (P=0.035) is smaller than that of the clear lens. The cell area of the lens epithelium in the cataractous diabetic lens is larger (P<0.001) and the nucleus-plasma ratio is lower (P<0.001) than those of the clear non-diabetic lens. The increase in damage of the lens epithelium correlates with the decrease of cell density (P< 0.001), the increase of nucleus area and volume (P< 0.001), and the decrease of nucleus-plasma ratio (P< 0.001). Risk factors for the decrease of cell density are advanced age (P=0.015), type II diabetes (P=0.01), increase in glucose content in the aqueous humour (P=0.014), increase in blood sugar (P=0.003) and increase in glycosylated haemoglobin (P=0.039).

Conclusions

The lens epithelium is primarily damaged in type II diabetics who develop age-related cataract. This might play an important role in cataract formation.

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Authors and Affiliations

  1. Department of Ophthalmology, Martin-Luther-University Halle-Wittenberg, Ernst-Grube- Str. 40, 06097, Halle/Saale, Germany

    Sergey I. Tkachov, Dirk Ehrich & Hans Gert Struck

  2. Institute of Medical Epidemiology, Biostatistics and Informatics, Martin-Luther-University Halle-Wittenberg, Halle/Saale, Germany

    Christine Lautenschläger

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  1. Sergey I. Tkachov
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  2. Christine Lautenschläger
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  3. Dirk Ehrich
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  4. Hans Gert Struck
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Correspondence to Hans Gert Struck.

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Tkachov, S.I., Lautenschläger, C., Ehrich, D. et al. Changes in the lens epithelium with respect to cataractogenesis—light microscopic and Scheimpflug densitometric analysis of the cataractous and the clear lens of diabetics and non-diabetics. Graefe's Arch Clin Exp Ophthalmo 244, 596–602 (2006). https://doi.org/10.1007/s00417-005-0091-7

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  • DOI: https://doi.org/10.1007/s00417-005-0091-7

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