Capsule thickness of cataractous lenses with and without exfoliation syndrome

Lens capsule thickness was measured in 105 cataractous lenses with and without exfoliation syndrome. The lenses were removed by intracapsular cryoextraction. Forty lenses (38%) showed exfoliation, while 65 (62%) were exfoliation negative. Thickness values were measured by light microscopy from the central anterior capsule, central posterior capsule and from the equator. The mean thickness values were for the central anterior capsule 8.2 +/- 3.2 mu, for the central posterior capsule 3.2 +/- 1.4 and for the equator 3.9 +/- 1.3. There was no statistical difference between the exfoliation-positive and exfoliation-negative lenses. The capsule thickness varied greatly throughout the present material. The highest value, 22.4 mu, was measured from an exfoliation-negative central anterior lens capsule of a male patient aged 33 years. The lowest value, 0.6 mu, was measured from an exfoliation-positive central posterior capsule of a male patient aged 64 years. The central posterior capsule is the thinnest area of the lens capsule. The findings call for great caution in polishing the posterior capsule during extracapsular cataract surgery. The higher complication rate in eyes with exfoliation syndrome cannot be explained by thinner lens capsules but rather on the more friable zonules.