Long-term myofibroblast persistence in the capsular bag contributes to the late spontaneous in-the-bag intraocular lens dislocation

Sci Rep. 2020 Nov 25;10(1):20532. doi: 10.1038/s41598-020-77207-7.

Abstract

Late spontaneous in-the-bag intraocular lens (IOL) dislocation is a complication presenting 6 months or later after cataract surgery. We aimed to characterize the cells in the lens capsules (LCs) of 18 patients with spontaneous late in-the-bag IOL dislocation. Patients' average age was 82.6 ± 1.5 years (range 72-98), and most of them had pseudoexfoliation syndrome (PEX). Cells from the LCs were positive for myofibroblast (αSMA), proliferation (Ki-67, PCNA), early lens development/lens progenitor (SOX2, PAX6), chemokine receptor (CXCR4), and transmembrane (N-cadherin) markers, while negative for epithelial (E-cadherin) marker. Moreover, the cells produced abundant fibronectin, type I and type V collagen in the nearby extracellular matrix (ECM). During ex vivo cultivation of dislocated IOL-LCs in toto, the cells proliferated and likely migrated onto the IOL's anterior side. EdU proliferation assay confirmed the proliferation potential of the myofibroblasts (MFBs) in dislocated IOL-LCs. Primary cultured lens epithelial cells/MFBs isolated from the LC of dislocated IOLs could induce collagen matrix contraction and continuously proliferated, migrated, and induced ECM remodeling. Taken together, this indicates that long-lived MFBs of dislocated IOLs might contribute to the pathogenic mechanisms in late in-the-bag IOL dislocation.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aged, 80 and over
  • Biomarkers / metabolism
  • Cell Movement
  • Cell Proliferation
  • Cells, Cultured
  • Collagen
  • Crystallins / metabolism
  • Epithelial Cells / metabolism
  • Epithelial-Mesenchymal Transition
  • Extracellular Matrix / metabolism
  • Female
  • Gene Expression Regulation
  • Humans
  • Lens Capsule, Crystalline / pathology*
  • Lens Subluxation / genetics
  • Lens Subluxation / pathology*
  • Lenses, Intraocular*
  • Male
  • Myofibroblasts / pathology*

Substances

  • Biomarkers
  • Crystallins
  • Collagen