Morphologic and ultra-structural features of anterior lens capsule in case of primary angle-closure glaucoma associated with pseudoexfoliation syndrome

    Purpose. To determine morphologic features of pseudoexfoliation deposits on the anterior lens capsule in case of primary angle-closure glaucoma (PACG).

    Material and methods. The investigation is based on an analysis of semi- and ultrathin sections of 34 anterior capsules extracted intra-operatively during capsulorhexis in cataract phacoemulsification surgery in patients with cataract and PACG.

    Preoperatively the degree of PEX manifestation was evaluated according to UBM data in accordance with a classification, first presented by Egorova E.V., Sarukhanyan A.A. (2007).

    The comparative group included 27 anterior capsules gained during cataract phacoemulsification in eyes of 23 patients with clinical PEX signs and analogous in degree of lens opacity maturity without glaucoma.

    Results. Presence of exfoliation deposits of various intensity and density on structures of anterior segments of the eye was observed in all ACG cases. There was noted a fact of analogy in morphologic manifestations of PEX stages in eyes without and with glaucoma.

    Detection of specific material on the external surface of anterior capsule during the light and electron microscopy in eyes with a pronounced clinical PEX symptomatology allows considering it as histological PEX manifestations. Morphologic and ultra-structural identity of revealed deposits both in PACG patients and in PEX eyes without glaucoma have every reason to establish a fact of PEX material presence in the investigated groups. Dependence between PEX stages on intensity, electron density and structure of pseudoexfoliation material was found in biopsy materials of anterior capsule independent of glaucoma presence. Correlation between PEX manifestations and glaucomatous process stages in PACG was not detected.

    Conclusions. Morphologic and ultra-structural PEX manifestations in histological research of biopsy materials of anterior capsule are independent of glaucoma type, but have a direct dependence on PEX stage determined by UBM findings.

    Key words: angle-closure glaucoma, pseudoexfoliation syndrome, morphology of lens capsule.