PURPOSE: To analyse the anterior lens capsule thickness and ultrastructure changes of intumescent white cataracts in comparison with nuclear cataracts to prove possible structural reasons for surgical difficulties with the intumescent white cataract. METHODS: Anterior lens capsules from 35 eyes with intumescent white and 35 eyes with nuclear cataracts were analysed for their thickness by semithin sections technique and for morphological characteristics by transmission electron microscopy. RESULTS: Capsule thickness was not significantly different in intumescent white compared to nuclear cataracts (mean values 17.5 and 18.5 μm, respectively, p = 0.369). The main morphological features of capsules were extrusions of capsule at the basement membrane-epithelial border embedding cellular material which were significantly more frequent in intumescent cataracts. Filaments in the basement membrane as well as rarefication of its structure and lamellae were often concomitant with the extrusions. CONCLUSIONS: Anterior capsules of white intumescent cataracts do not differ in thickness but have different ultrastructure morphology compared to nuclear cataracts. The extrusions of basement membrane at the basement membrane-epithelial border towards epithelium, the filamentary inclusions within basement membrane and its rarefication could be the structural causes of tensile weakness and hence additional reason to surgical problems.
PURPOSE: To analyse the anterior lens capsule thickness and ultrastructure changes of intumescent white cataracts in comparison with nuclear cataracts to prove possible structural reasons for surgical difficulties with the intumescent white cataract. METHODS: Anterior lens capsules from 35 eyes with intumescent white and 35 eyes with nuclear cataracts were analysed for their thickness by semithin sections technique and for morphological characteristics by transmission electron microscopy. RESULTS: Capsule thickness was not significantly different in intumescent white compared to nuclear cataracts (mean values 17.5 and 18.5 μm, respectively, p = 0.369). The main morphological features of capsules were extrusions of capsule at the basement membrane-epithelial border embedding cellular material which were significantly more frequent in intumescent cataracts. Filaments in the basement membrane as well as rarefication of its structure and lamellae were often concomitant with the extrusions. CONCLUSIONS: Anterior capsules of white intumescent cataracts do not differ in thickness but have different ultrastructure morphology compared to nuclear cataracts. The extrusions of basement membrane at the basement membrane-epithelial border towards epithelium, the filamentary inclusions within basement membrane and its rarefication could be the structural causes of tensile weakness and hence additional reason to surgical problems.