The ultrastructural alterations in the lens capsule and epithelium in eyes with traumatic white cataract

To demonstrate the morphological and physiological characteristics of lens epithelial cells (LECs) in patients with traumatic cataract using transmission electron microscopy (TEM) to further understand penetrating ocular injury-induced cataract morphology and epithelial repair mechanisms involved at a cellular level. This is a prospective international study. Sixteen eyes of 16 consecutive patients who were diagnosed as traumatic white cataracts following the anterior lens capsule perforation and 13 eyes of 13 patients with idiopathic posterior subcapsular cataract were included to the study. The anterior lens capsules (aLCs: basement membrane and associated LECs) were obtained from cataract surgery and prepared for TEM. Two prominent cell types were observed in all aLCs of the traumatic cases: degenerated type LECs having variable sized intraepithelial vacuoles close to injury site and normal appearing LECs having an euchromatic nucleus distant from the injury site. In control group, the LECs and all their elements were in normal ultrastructural pattern except some small intraepithelial vacuoles, which were fewer and smaller than the vacuoles in the degenerated LECs of the traumatic group. The ultrastructural findings of our cases support that traumatically induced dysfunction of the lens epithelium may lead to an edema in superficial cortical lens fibers that subsequently undergo degeneration and produce a localized zone of vacuolization.