THE INFLUENCE OF DIABETES-MELLITUS ON THE ANTERIOR CENTRAL LENS EPITHELIUM OF CATARACT PATIENTS

The relationship between diabetic metabolic disorder and the impairmen t of lens epithelium in the development of age-related cataract cannot be completely defined yet. In this prospective study,morphological cr iteria and the phosphorus content of the anterior central lens epithel ium in type-it diabetics and nondiabetics are compared. Patients and m ethods: Fifty-six of the overall 159 patients with age-related catarac ts were suffering from type-ii diabetes (group I) and 103 are nondiabe tics (group II). In each case,a fragment of the anterior central lens epithelium was evaluated morphologically using a scanning electron mic roscope (S-2400) and examined by EDXA (X-ray spectrometer TN-5500), wi th regard to phosphorus content. The criteria considered were the degr ee of damage to the epithelium (score 1 - 3),the morphologically evalu ated cell density and the ''peak/background'' relationship for phospho rus. Results: The mean degree of damage to the epithelium was 1.48+/-0 .53 in the type-it diabetic group (I) and 1.55+/-0.65 in the nondiabet ic group (II), respectively. The median cell density of type-ii diabet ics (group I) was 4838+/-1033 cells/mm(2) compared with 5454+/-1368 ce lls/mm(2) of the nondiabetics (group II). The mean ''peak/background'' relationship for phosphorus was 0.46+/-0.20 in group I and 0.51+/-0.2 6 in group II, respectively. Conclusion: In the younger patients, the significant decrease in cell density and the increased degree of damag e to the anterior central lens epithelium in the type-ii diabetic grou p could be attributed to the cataractogenic influence of diabetic meta bolic disorder on the lens epithelium. Another possible indication for that was the smaller phosphorus content in this group as evidence of the decrease in the biological activity of the cells (ATP-function). T he primary cataractogenic importance of the lens epithelium in type-ii diabetics could not be concluded.