Clinicobiochemical correlations in aging-related human cataract. The Pan American Association and American Journal of Ophthalmology lecture.

In a series of 50 consecutive adult patients (24 men and 26 women) we studied aging-related cataract by means of comprehensive presurgical examination of the patient, the eyes, and the cataractous lens; cataract sample collection from predetermined sites during surgery; biochemical analyses with high-performance liquid chromatography of each individual lens sample; and computer-assisted biostatistical data analysis. Compared with normal values established on clear human lenses obtained from a donor eye program, the ratios of 23,000 (23K) crystallin to total beta, gamma, and low molecular weight soluble proteins were statistically significantly lower in the anterior axial lens cortex (P less than .001) and in the lens nucleus (P less than .001). Increased grades of cortex opacification and nucleus opacification were generally associated with progressively decreased 23K crystallin ratios. In this series of patients with diverse cataract-associated systemic diseases, family histories, ophthalmic disorders, and drug-use patterns, decreased 23K crystallin ratios were a sensitive marker for aging-related cataract. Similar biochemical abnormalities in patients with multiple cataract-associated factors may have important clinical implications.