Straatsma B R, Lightfoot D O, Barke R M, Horwitz J
Jules Stein Eye Institute, University of California, Los Angeles 90024-7000.
Am J Ophthalmol. 1991 Sep 15;112(3):283-96. doi: 10.1016/s0002-9394(14)76729-7.
On the basis of preoperative assessment of patient characteristics, intraoperative obtainment of a lens-capsule and epithelium specimen, histopathologic investigation of lens capsule and epithelium, and biochemical analysis of glutathione reductase in lens epithelium, age-related cataract was studied in 50 adult patients who underwent consecutive extracapsular cataract-posterior chamber lens implant surgery. Patients (25 men and 25 women; age range, 41 to 91 years; mean age, 75 years) had a wide range of systemic and ocular disease; 17 of 50 (34%) patients had a history of severe vision-impairing cataract in a first-degree relative. Anterior lens-capsule thickness ranged from 10 to 22 microns, with a mean of 17 microns. Statistical analysis of lens-epithelium ultrastructure in 41 of 50 specimens documented mixing of normal and abnormal cells, verified a gradation in the degree of abnormal ultrastructural features, and demonstrated a statistically significant decrease in epithelial cytologic activity with advancing age (P = .038). Biochemical analysis documented a severe glutathione reductase deficiency in nine of 39 (23%) lens-epithelium specimens, possibly reflecting a dietary deficiency of riboflavin.
基于对患者特征的术前评估、术中获取晶状体囊膜和上皮细胞标本、对晶状体囊膜和上皮细胞进行组织病理学研究以及对晶状体上皮细胞中谷胱甘肽还原酶进行生化分析，我们对50例连续接受囊外白内障摘除联合后房型人工晶状体植入手术的成年患者的年龄相关性白内障进行了研究。患者（25名男性和25名女性；年龄范围为41至91岁；平均年龄为75岁）患有多种全身性和眼部疾病；50例患者中有17例（34%）有一级亲属患严重视力损害性白内障的病史。晶状体前囊膜厚度为10至22微米，平均为17微米。对50个标本中的41个进行晶状体上皮超微结构的统计分析记录了正常细胞与异常细胞的混合情况，证实了异常超微结构特征程度的分级，并显示随着年龄增长上皮细胞活性在统计学上显著降低（P = 0.038）。生化分析记录了39个晶状体上皮细胞标本中有9个（23%）存在严重的谷胱甘肽还原酶缺乏，这可能反映了饮食中核黄素的缺乏。
