Ultrastructural Findings Of The Anterior Lens Capsule In A Case Of Adult Anterior Polar Cataract Achyut Mukherjee1, Saeed Akhtar2, Amit Patel1, Vinod Kumar1 1:University Hospital of Wales, Cardiff, United Kingdom. 2: Department of Optometry and Vision Sciences, Cardiff University The authors have no financial interest.

Methods An adult patient with clinical anterior polar cataract underwent routine phakoemulsification cataract surgery The anterior capsule was removed intraoperatively by continuous curvilinear capsulorrhexis, and this specimen was subjected to ultrastructural examination

Methods The lens epithelium and basement membrane was fixed in 2.5% glutaraldehyde in 0.1M molar phosphate buffer at 4C for 4 hours The tissue was subsequently washed with 0.1M molar phosphate buffer and dehydrated with series of graded ethanol. The tissue was then fixed and embedded in spurrs resin. Ultrathin sections were stained with uranyle acetate and lead citrate The prepared sample was studied using transmission electron microscopy

Light microscopic findings B E L B E L Light microscopy B: basement membrane (capsule), E: epithelium L: sub-epithelial material of the pathological lens

Ultrastructural findings - lens epithelial cells V E: Epithelium B: Basement membrane V: Vacuole Ultrastructural studies showed lens epithelial cells that were severely damaged. The cells showed electron lucent vacuolation and disruption.

Ultrastructural findings - lens epithelial cell nucleus Epithelial cell nuclei appeared degenerate

Conclusion Previous histological studies of anterior polar cataract have describes fibrous metaplasia as being present Lens epithelial hyperplasia and subepithelial lens fiber necrosis has also been suggested as a pathological finding In this case, there was some evidence of hyperplastic changes, although no fibrous metaplasia was present.

Conclusion The role of epithelial cell dysfunction in anterior polar catarct remains uncertain. Past series of flat anterior polar cataract have shown relatively normal cuboidal epithelial cells. In our case, however, the changes were marked degenerative alterations at an ultrastructural level. This difference may partly relate to the duration of pathology: most histological series are in children, while this was an adult patient. In the case of pyramidal anterior polar cataract, degenerate and absent epithelium have been reported, similar to our findings in this case.

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