[Findings from slit lamp and histological examination of the anterior capsule in patients with severe anterior capsular shrinkage and opacities after implantation of intraocular lenses].

Seven pseudophakic patients with severe anterior capsular shrinkage and opacities after continuous curvilinear capsulorhexis as a severe anterior capsular shrinkage group and seven pseudophakic patients without the complication as control group were studied in a slit lamp examination of zonular fibers and anterior vitreus body with an indentation mirror. A light and electron microscopic study of the shrunken anterior capsular edge was performed in one case of the severe anterior capsular shrinkage group. No morphological findings suggesting weakness of zonular fibers such as cleavage or scarceness were observed, but reduction in elasticity of the zonular fibers was surmised and degeneration and liquefacation of the anterior vitreus body was observed in the severe anterior capsular shrinkage group. Histological study revealed several layers of proliferated spindle cells and also abundant extracellular matrix, consisting of collagen types I, III and IV, under the monolayer of lens epithelium attached to the anterior capsule. Spindle cells were epithelial cells and considered to be derived from lens epithelium, because the spindle cells were connected by junctional apparatus, which is a feature of epithelium. Severe anterior capsular shrinkage and opacities were due to low ability of the lens supporting system of zonular fibers and anterior vitreus and severe scarring and shrinkage at the anterior capsular edge.