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Zeliha Yazar, Mustafa Kilic, Esra Erdemli, Ferda Topal Celikkan; Ultrastructural Changes In The Crystalline Lens Of Diabetic Patients Treated With Panretinal Argon Laser Photocoagulation. Invest. Ophthalmol. Vis. Sci. 2012;53(14):6709.
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© ARVO (1962-2015); The Authors (2016-present)
To investigate the effect of panretinal photocoagulation on the crystalline lens anterior capsula and lens epithelial cells.
This prospective, histological, mono-blind study was performed on 20 consecutive cases (20 eyes) who undergone to uncomplicated phacoemulsification surgery for senile nuclear sclerosis (P-1 or less, N-V, C-1 or less according to LOCS). Age of patients varied between 60 to 75 years. They had no complicating systemic or ocular disease except type-2 diabetes mellitus (DM) and hypertension. They were divided into groups according to (1) presence of DM, (2) severity of diabetic retinopathy (DR), and (3)argon laser panretinal photocoagulation (PRP) performed at least 6 months earlier. Lens anterior capsula materials taken from all the patients during phacoemulsification operation were examined with transmission electron microscopy (TEM) by the same treatment-blind histologist. The histo-morphological results were interpreted comparatively.
All the groups were similar in terms of age and gender distrubution and HbA1c levels in DM (p>0.05 for all).TEM showed no pathological changes in basal membrane in anterior capsule. Filamantous accumulations in the apical surface of the cells were present in nondiabetic control eyes. Sporadic disintegrations in lens epithelial cells (LEC) together with weakening in intercellular connections and mild cell degeneration were observed in eyes with mild nonproliferative DR (NPDR) without PRP. More patchy disintegrations in LEC, weaker intercellular connections, big vacuoles in the cell cytoplasm, picnotic nucleus, and severe degeneration and apoptotic cells with lipid inclusions were noted in eyes with severe NPDR without PRP. In addition to these findings, blebs and surface protrusions compatible with severe degeneration and apoptosis were evident in eyes with PDR and PRP.
Crystalline lens epithelial cells seems to undergo ultrastructural senescence compatible with the severity of diabetic retinopathy. Argon laser panretinal photocoagulation may accelerate this process through apoptosis.
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