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

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.

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

“…Furthermore, the involvement of myofibroblasts in CBD has been reported in pseudoexfoliation syndrome. 16 In this study, we observed low-density fibrosis in the AD group and a qualitative comparison of myofibroblasts in the capsules of the AD and non-AD groups may be useful.…”

Inhibition of suppressor of cytokine signaling‐3 affects mesangial cell proliferation and cell cycle in mesangioproliferative glomerulonephritis

“…Proliferating cell nuclear antigen (PCNA) and Ki-67 are two indicators that can well delineate the proliferation of cells. 28 F I G U R E 7 Expression of Cyclin A, Cyclin D1, PCNA, and Ki-67 in primary mouse renal mesangial cells (MRMCs, A) and SV40 MES-13 cells (B). * P < 0.05 versus Blank group and Control activation particles group; # P < 0.05 versus SOCS-3 activation particles group; & P < 0.05 versus SOCS-3 siRNA group.…”

Exploring anterion capsular contraction syndrome in cataract surgery: insights into pathogenesis, clinical course, influencing factors, and intervention approaches

“…After 3 months, the contraction of the capsular bag slows down and tends to stabilize ( 4 , 17 ). However, with recent in-depth studies, we have found that the course of ACCS can develop in the weeks to years following surgery and in high-risk patients such as those with pseudoexfoliation (PEX), high myopia, and RP, the incidence of ACCS may increase to 10% to 30% or more ( 18 , 19 ). Furthermore, a comprehensive population study with a 30 years follow-up indicates that late in-the-bag IOL dislocation can occur after cataract surgery, ranging from 6 months to 25 years or even longer, and it is associated with zonular dehiscence and capsular bag contraction ( 20 , 21 ).…”

“…This can further contribute to the occurrence of ACCS. Additionally, PEX is the most common underlying condition for spontaneous in-the-bag IOL dislocation ( 19 ). It is currently believed that implanting a CTR or postoperative use of nonsteroidal anti-inflammatory drugs (NSAIDs) can be effective in reducing postoperative ACCS in patients with PEX ( 62 , 67 , 68 ).…”