R 209Are diabetic diseases a risk factor for cataract in older people?
H. G. Struck, C. Heider, C. Lautenschläger
Background: The higher prevalence of diabetes for cataract as a component of the multifactorial genesis of age-related cataract is proved in different clinical studies.
Diabetic hyperglycaemia causes increased formation of g1ucose-derived advanced glycation cytotoxic end-products. In connection with these specific pathological changes the crucical role of the lens epithelium with respect to cataractogenesis has to be further evaluated. Therefore in a prospective clinical study, we examined and compared the morphological characteristics of human lens epithelium of age-related cataracts in type-n-diabetics and nondiabetics.
Patients and Methods: 30 (16 female, 14 male, mean age 73.0 years) of the overall 59 patients with age-related cataract suffering from type-n-diabetes were assigned to group I and 29 nondiabetics (16 female, 13 male, mean age 68.2 years) to group n, and operated by phacoemulsification and lens implantation. Age, sex, type of cataract and the blood parameters fasting blood sugar and g1ycolized hemog1obin were further parameters. After surgery the collected hematoxylin-eosin stained anterior central lens capsules with attached lens epithelial cells were analyzed by light microscope for the cell parameters cell density (morphometIy), nucleus area (Ao), nucleus volume (V), cell area (A) and nucleus-plasma-ratio.
Results: The mean cell density in type-n-diabetics (group I) is 3691 :!: 346 cells/mm2 and in nondiabetics (group n) 4162 :!: 504 cells/mm2, respectively (p=0 .00 1 ). A decrease of the mean cell density could be attributed to age only in the nondiabetic group. The mean nucleus area and -volume and cell area are in the type-n-diabetic group significant1y larger than in nondiabetics. The mean nucleus- plasma-ratio in type-n-diabetics is lower than in nondiabetics and decreased with age.
Conclusions: The significantly lower mean cell density in type-n-diabetics compared with nondiabetic eyes seems together with the other detetmined morphological cell characteristics to be due to the cataractogenic influence of diabetic metabolic disorder on the lens There are some clues for the primary cataractogenic importance ofthe lens epithelium in type-n-diabetes.
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