Organization of collagen and other extracellular material in anterior capsular cataract

Capsular cataract takes the form of a white-grey opacity appearing under the anterior lens capsule (anterior subcapsular cataract). The capsule is wrinkled through the action of myofibroblast-like cells developed from the anterior lenticular epithelium. The myofibroblast-like cells also produce collagen that takes on a dysplastic appearance. Collagenous microfibrils accumulate to form fibre-like aggregations. These aggregations represent an abnormal collagen density (collagen condensation or attraction) in comparison to normal collagenous fibrils and fibres. Within the anterior capsular cataract 4 topological regions may be distinguished: Cell regions (1), stratification regions (2), aggregation regions (3), and intermediate regions (4). It is postulated that these regions represent different stages in the maturation and degradation of collagen, in the absence of phagocytic elements.