Özer Ferhad, İnanç İrem, Kızıltunç Pınar B, Atilla Hüban, Can Belgin
Ophthalmology Department, Ankara University Faculty of Medicine, Mamak, Ankara, Türkiye.
Histology and Embryology Department, Ankara University Faculty of Medicine, Mamak, Ankara, Türkiye.
Indian J Ophthalmol. 2024 Dec 1;72(12):1741-1744. doi: 10.4103/IJO.IJO_2957_23. Epub 2024 May 20.
To investigate the histopathological findings of the anterior lens capsule in pediatric patients who had surgery for cataracts.
This study is a prospective interventional study. Anterior capsule tissue samples that were obtained by the anterior capsulotomy method during phacoemulsification surgery were fixed and examined under a transmission electron microscope.
Twenty-two eyes of 19 patients who were diagnosed with congenital and juvenile cataracts were included in this study. Five patients had associated systemic diseases, including hydrocephalus, cerebral palsy, prematurity, juvenile myelomonocytic leukemia, and Down's syndrome. Electron microscopic evaluation demonstrated single-layered epithelium under the capsule, degenerated organelles with round-oval and prismatic-oval nuclei, and degenerated mitochondria and heterochromatin-rich nuclei. In the case with cerebral palsy, collagen fibrils of the connective tissue and fibroblast-like cells were observed replacing the epithelium that should be underneath the capsule in both eyes, and there was a disorganized distribution of collagen fibrils and vacuole structures in the cytoplasm of fibroblast-like cells.
Similar histopathological findings were found in pediatric cataracts with or without systemic disease except in one cerebral palsy case. The absence of lens epithelium may have been a result of degeneration in this patient, and this can be attributed to the presence of systemic inflammation and gliosis in cerebral palsy. The absence of lens epithelium can play a role in the development of dense subcapsular fibrosis and cataract formation.
研究接受白内障手术的小儿患者晶状体前囊的组织病理学表现。
本研究为前瞻性干预性研究。对在超声乳化手术中通过前囊切开术获取的前囊组织样本进行固定，并在透射电子显微镜下检查。
本研究纳入了19例诊断为先天性和青少年性白内障患者的22只眼。5例患者伴有全身性疾病，包括脑积水、脑瘫、早产、青少年型粒单核细胞白血病和唐氏综合征。电子显微镜评估显示，囊膜下为单层上皮，细胞器退化，细胞核呈圆形 - 椭圆形和棱柱形 - 椭圆形，线粒体退化，细胞核富含异染色质。在脑瘫患者的病例中，观察到双眼结缔组织的胶原纤维和成纤维细胞样细胞取代了囊膜下本应存在的上皮，并且成纤维细胞样细胞的细胞质中胶原纤维和液泡结构分布紊乱。
除1例脑瘫病例外，患有或未患有全身性疾病的小儿白内障患者具有相似的组织病理学表现。该患者晶状体上皮的缺失可能是退化的结果，这可归因于脑瘫中全身性炎症和胶质增生的存在。晶状体上皮的缺失可在致密的囊下纤维化和白内障形成的发展中起作用。
