Purpose: The aim of the present study was to demonstrate novel findings recognized within the basement membrane of the anterior lens capsules (ALCs) in exfoliation syndrome, in a transmission electron microscopy (TEM) study. Materials and methods: Twenty-one patients with age-related cataract were included in the study. Eleven out of them suffered from exfoliation syndrome (XFS). Anterior lens capsules were obtained from patients during phacoemulsification, applying continuous curvilinear capsulorhexis and then were examined by transmission electron microscope. Results: Six out of 11 examined basement membranes with XFS had a granular appearance with dotted deposits of electron-dense material. Fibrils were clearly detected, longitudinally, within the basement membrane, usually located in the outer quarter of the basement membrane, towards the anterior chamber. Conclusion: New data about the exfoliation material and its location within the basement membrane of the anterior lens capsules of XFS patients are presented. These findings constitute new evidence for XFS's histopathogenesis and might help clarify the lenticular exfoliation material's (XFM) mechanisms of origin.
Keywords: Exfoliation syndrome; anterior lens capsule; basement membrane; fibrils; transmission electron microscopy.