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@#AIM: To investigate the effect of LECs removal on the stability of lens capsule bag in patients with high myopia.<p>METHODS: From March 2018 to April 2019, 98 cases(120 eyes)of cataract patients with high myopia were treated in Cataract Department of Hebei Province Eye Hospital. They were divided into two groups according to whether the LECs were removed during the operation. In group A, the anterior and posterior capsule were polished in 50 cases(60 eyes), while in group B, 48 cases(60 eyes)were not polished. During the follow-up period we used anterior segment OCT to detect the change of effective intraocular lens position(ELP), the eccentricity of intraocular lens(IOL)and the reduction of anterior capsule opening in the two groups, and used slit lamp to observe the occurrence and degree of PCO.<p>RESULTS: We compared the changes of ELP(0.16±0.06mm <i>vs</i> 0.55±0.07mm)and the changes of contraction of anterior capsule(0.18 ± 0.16mm <i>vs</i> 0.92 ± 0.13mm)on the first day and three months after operation. Three months after operation, we compared the IOL eccentricity of the two groups(0.02±0.005mm <i>vs</i> 0.69±0.23mm). There were differences between the two groups(<i>P</i><0.05). At 3mo after operation, the PCO of group A was observed by slit lamp: grade I 4 eyes, grade II 2 eyes, grade III 1 eye. The PCO of group B: grade I 16 eyes, grade II 8 eyes, grade III 4 eyes and grade IV 3 eyes. There was significant difference between the two groups(<i>Z</i>=-4.765, <i>P</i><0.01).<p>CONCLUSION: The removal of LECs could reduce the contraction of anterior capsule, decrease the change of ELP and enhance the stability of bag IOL complex, which played a good role in reducing PCO.
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By using RT-PCR and immunohistochemistry, the expressions of transforming growth factor β2 (TGF-β2) mRNA, proliferating cell nuclear antigen (PCNA) and fibronection (FN) protein in lens epithelial cells (LECs) of age-related nuclear and cortex cataract were detected and compared. The results of RT-PCR revealed that the expression of TGF-β2 mRNA was higher in cortex cataract than in nuclear cataract. Immunohistochemistry demonstrated that the expression of PCNA protein was lower and the expression of FN protein was higher in cortex cataract than in nuclear cataract. It was suggested that TGF-β2, PCNA and FN might take important parts in the process of age-related cataract. Cortex cataract was related to the transdifferentiation of LECs, and nuclear cataract to the proliferation of LECs.
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Degeneration and transformation of lens epithelial cells (LECs) have been regarded as major causes of cataract and after-cataract. So behaviors of LECs have been studied in order to prevent some kinds of cataract and after-cataract, mainly in vitro. This study identified in vivo that human LECs beneath the anterior capsule were transformed in anterior polar type of cataract. Normal LECs showed positive staining for both cytokeratin and virnentin, while transformed LECs in the anterior polar type of cataractous lens were positive for vimentin only. Additionally, these transformed LECs seern to be fibrocytes without cellular junctions, are vertically or obliquely oriented, and spindle-shaped. These cells were embedded within 8 fibrillar meshwork rnass secreted by themselves. With this result it was found that LECs could be transformed into fibroblat like cells and this transformation of LECs were observed in anterior polar type of cataractous lens.