Cataracts in the exfoliation syndrome (fibrillopathia epitheliocapsularis)

The histopathological features of the lenticular part of the exfoliation syndrome includes active production of pathological capsular substance in the epithelial cells in the zona germinativa. Analysis of the cataract pattern of 431 exfoliation lenses and 1776 control lenses extracted at the Massachusetts Eye and Ear Infirmary shows a significant difference. Cortical and supranuclear cataract is less common and severe in the exfoliation syndrome, while the reverse is true for nuclear cataract. Posterior subcapsular cataract shows no difference while the anterior variety is slightly more common in the control group. It is suggested that the high level of epithelial metabolic activity may be beneficial for the ionpumps and electrolyte environment of the cortical fibres.