Lens capsule pathological characteristics in cases of intraocular lens dislocation with atopic dermatitis

Koji Komatsu; Yoichiro Masuda; Ai Iwauchi; Hoshiho Kubota; Masanobu Iida; Kosuke Ichihara; Masami Iwamoto; Kenji Kawai; Naoki Yamamoto; Masayuki Shimoda; Tadashi Nakano

doi:10.1097/j.jcrs.0000000000001413

Lens capsule pathological characteristics in cases of intraocular lens dislocation with atopic dermatitis

J Cataract Refract Surg. 2024 Feb 6. doi: 10.1097/j.jcrs.0000000000001413. Online ahead of print.

Authors

Affiliations

¹ Department of Ophthalmology, The Jikei University School of Medicine, Minato-ku, Tokyo, Japan.
² Department of Pathology, TheJikei University School of Medicine, Minato-ku, Tokyo, Japan.
³ Department of Ophthalmology, Tokai University School of Medicine, Isehara, Kanagawa, Japan.
⁴ Support Office for Bioresource Research, Center for Translational Research, Translational Research Headquarters, Fujita Health University, Toyoake, Aichi, Japan.

PMID: 38350154
DOI: 10.1097/j.jcrs.0000000000001413

Abstract

Purpose: To explore lens capsule pathological characteristics in intraocular lens (IOL) dislocation following cataract surgery in patients with atopic dermatitis (AD).

Setting: University hospital department of ophthalmology.

Design: Case series with clinicopathological correlations.

Methods: Lens capsules and surrounding tissues excised during surgery from eyes with AD (AD group) and eyes without AD (non-AD group) with IOL dislocation were histologically evaluated. Hematoxylin and eosin staining was used to assess abnormal changes in lens epithelial cells (LECs). Masson's trichrome staining distinguished the fibrous metaplasia around the lens capsule into high- and low-density fibrosis. Capsular splitting (thinning) was identified in both stained preparations.

Results: The IOL dislocation morphology in the AD group (10 eyes of 10 patients) included 7 cases of capsular bag dislocation (CBD) and 3 cases of dead bag syndrome (DBS), with an average duration to IOL dislocation of 11.5±5.6 years. All patients in the non-AD group (12 eyes of 12 patients) had CBD, averaging 10.2±5.7 years to dislocation. Abnormal LECs, low-density fibrosis, and capsular splitting were observed in 9 (90), 9 (90), and 6 (60) of the patients in the AD group, respectively, compared to 6 (50), 3 (25), and 2 (18), respectively, in the non-AD group (Total n(%)).

Conclusions: Compared to the non-AD group, the AD group exhibited higher frequencies of morphological changes in LECs, low-density fibrosis around the lens capsule, and capsular splitting characteristics of DBS. These results suggest lens epithelial cells degeneration and increased lens capsule fragility occurred in patients with AD.