Electron Microscopic Investigation of Anterior Lens Capsule and Epithelium in Patients with Diabetes Mellitus

Purpose: To evaluate the histopathologic alterations of organelles in the epithelium of the anterior lens capsule. Methods: The interventional study included 26 eyes; of which 11 had non-proliferative diabetic retinopathy (diabetic group) and cataract, and 15 had age-related cataract (control group). We investigated the anterior lens capsule in patients with diabetes mellitus by using electron microscopy and to compare it between diabetic eyes and healthy eyes. Anterior capsule samples were obtained by circular continuous capsulorhexis during phacoemulsification procedures. All the samples were fixed and conventionally processed for electron microscopy analysis. Results: Demographic characteristics of the diabetic group and the control group were similar (p > 0.05). In the diabetic group, electron dense cells with an apoptotic appearance were seen and these cells had an apoptotic nucleus and prominent mitochondrial crystalysis. In addition, there was dilatation of the endoplasmic reticulum cistern. In the control group, lens epithelial cells and all their elements had a normal pattern. Neither cells with an apoptotic appearance nor mitochondrial crystalysis was seen, but there was dilatation of the endoplasmic reticulum cistern. Conclusions: Diabetes mellitus can engender structural abnormalities of organelles in the epithelium of the anterior lens capsule including mitochondrial crystalysis, dilatation of the endoplasmic reticulum cistern and apoptotic dense nucleus. It can be suggested that diabetes mellitus affects organelles of anterior lens epithelium in eyes with cataracts, while it causes non-proliferative changes in the retina.