gms | German Medical Science

102. Jahrestagung der DOG

Deutsche Ophthalmologische Gesellschaft e. V.

23. bis 26.09.2004, Berlin

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Changes of the lens epithelium with respect to cataractogenesis: light-microscopic and Scheim-pflug-densitometric analysis of the lens opacification and the clear lens of diabetics and nondiabetics

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  • corresponding author S. I. Tkachov - Department of Ophthalmology, Martin-Luther-University Halle-Wittenberg
  • H. G. Struck - Department of Ophthalmology, Martin-Luther-University Halle-Wittenberg
  • C. Lautenschlager - Inst. of Med. Epidemiology, Biostatistic and Informatics, Martin-Luther-University Halle-Wittenberg

Evidenzbasierte Medizin - Anspruch und Wirklichkeit. 102. Jahrestagung der Deutschen Ophthalmologischen Gesellschaft. Berlin, 23.-26.09.2004. Düsseldorf, Köln: German Medical Science; 2004. Doc04dogDO.04.01

The electronic version of this article is the complete one and can be found online at: http://www.egms.de/en/meetings/dog2004/04dog033.shtml

Published: September 22, 2004

© 2004 Tkachov et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.

Outline

Text

Objective

The cataractogenesis of the age-related cataract in type II diabetics and the role of the lens epithelium in this process is to be further explained. Within the scope of this prospective clinical study, histomorphological changes of the lens epithelium of the lens opacification and clear lens in type II diabetics and nondiabetics were analysed by light microscope and examined.

Methods

150 central lens capsules (138 cataract and 12 clear lenses) of type II diabetics (n=77, 45 female, 32 male) and nondiabetics ( n=73, 41 female, 32 male) were gained and examined by light microscope after phacoemulsification. The histomorphological parameters were defined as cell density, nucleus volume, cell area, nucleus area, nucleus-plasma-ratio and the definition of the grade of damage of the lens epithelium (I-none, II-low damaged, III - badly damaged). Further criteria were duration of diabetes, diabetic retinopathy, different types of cataract (PENTACAM, scheimpflugdensitometric definition), protein content in anterior chamber (Laser-Flare-Meter 500 KOWA, tyndallometry); the blood parameters fasting blood sugar and glycolized hemoglobin and glucose content in anterior chamber.

Results

The mean cell density in the cataractous lens in type II diabetics is 3951±528 cells/mm2, in nondiabetics 4329±580 cells/mm2 (p<0,001) and in clear lens it behaves corresponding 4593±409 cells/mm2 (type II diabetics) and 4894±333 cells/mm2 (nondiabetics, p=0,207). The cell density of the cataractous lens in type II diabetics (p=0,005) as well as in nondiabetics (p=0,035) is smaller as 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) then of the clear nondiabetic lens. The increasing damage of the lens epithelium correlates with decreasing cell density (p<0,001), increasing nucleus area and volume (p<0,001), and decreasing nucleus-plasma-ratio (p<0,001). Rriskofactors for the decreasing cell density are advanced age (p=0,015), type II diabetes (p=0,01), increasing glucose content in anterior chamber (p=0,014), increasing blood sugar (p=0,003) and increasing glycolized hemoglobin (p=0,039).

Conclusions

The early changes of the lens epithelium of clear lens in type II diabetics and significant differences of the characteristics of the lens epithelium in cataractous diabetic lens compared to the normal transparent nondiabetic lens point out the lens epithelium as primary damaged structure in the cataractogenesis of the age-related cataract in type II diabetics.