Electron microscopic study on the development of precapsular layer in eyes with exfoliation syndrome.

Abstract Purpose: To search for a pathogenic mechanism for the formation of the precapsular layer on the anterior lens surface in pre-exfoliative eyes. Methods: We examined anterior lens capsules obtained during surgery from 38 patients (control, 16; exfoliation suspect, 10; exfoliation, 12) by transmission electron microscopy. Results: A precapsular layer was found in 5 of 16 controls and 7 of 10 exfoliation suspects. It was composed mainly of microfibrils 5–8 nm in diameter. Degenerated zonular fragments were occasionally found interspersed in, and sometimes merged with microfibrils of the precapsular layer. Conclusion: Zonular fibers might contribute to the formation of the precapsular layer in pre-exfoliation stages.