In many older patients we observed a layer of subtle opacification on the anterior lens capsule, appearing as a ground glass film biomicroscopically. This precapsular film (PCF) could be uniform but often had radial grey lines in the mid zone, holes in the paracentral region, and was occasionally rolled up in strings. Lens capsular material obtained at cataract extraction was studied in patients with and without the film. By scanning electron microscopy the PCF appeared as a friable, incomplete fibrillar layer, with rolling of the edges suggesting loose attachment. Ultrastructurally its component fibrils were from 3-6 nm in diameter, similar to the finer fibrils in pseudoexfoliation (PSX) material. Life PSX material the layer stained positively for the elastic microfibril-associated protein, fibrillin, in a lens with radial striations. These similarities suggested that the two conditions have some relationship and that the PCF may be a precursor of PSX. Finding patches of the fibrillar network in some control patients implies that the PCF is common in patients of cataract age, though seldom detected clinically.
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机译:在许多老年患者中,我们在前晶状体囊膜上观察到了一层微妙的浑浊,在生物显微镜下表现为毛玻璃膜。这种预封装膜(PCF)可以是均匀的,但通常在中间区域有放射状的灰线,在中央附近区域有孔,并且偶尔成串卷起。在有或没有膜的患者中研究了白内障摘除后获得的晶状体囊材料。通过扫描电子显微镜观察,PCF表现为易碎,不完整的原纤维层,边缘滚动表明附着较松散。在超微结构上,其成分原纤维直径为3-6 nm,类似于假脱落(PSX)材料中的较细原纤维。 Life PSX材料在带有放射状条纹的晶状体中,该层对与弹性微原纤维相关的蛋白质原纤维蛋白呈阳性染色。这些相似之处表明,这两个条件具有一定的关系,并且PCF可能是PSX的前身。在一些对照患者中发现原纤维网络的斑块表明,PCF在白内障年龄患者中很常见,尽管在临床上很少发现。
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