The Cause of Cataracts P.3






(2) Destruction of the human lens cell by the lens capsule



(2) Destruction of the human lens cell by the lens capsule

As soon as I started digging up previous literature, I found a document by David G. Cogan.4 In the document, the answer to the cause of cataracts was written. It was revealed by the excellent researcher, David G. Cogan. He indicated that the beginning of wedge-shaped cataracts was crush of lens cells. In Cogan's paper, gPathology of Age-Related Cataracts (1990),h the next sentences are described with a microphotograph.

gBalloon cell formationh (Fig.2-1)

gThis type of formation is seen predominantly in the subcapsular regionespecially conspicuous in the equatorial regions where a mosaic of balloon cellswith or without nucleioccupy the region corresponding to the usual bow configuration (Fig.4). Occasionally clusters of balloon cells are also found deeper in the cortex suggesting that they have been displaced inward by the subsequent formation of new lens fibers.

 A tentative explanation for the balloon cell metamorphosis is that the equatorial epitheliumunable to develop a fiber configurationundergoes an aberrant maturation with increase in cytoplasm and loss of nuclei ; the cells form balls instead of fibers. Of course, this interpretation still leaves open the question of why the cells have lost their ability to differentiate into normal fibers in the first place.

The relation between the balloon cells and other forms of corticolysis is unclear. It seems likelyhoweverthat as the balloon cells further disintegratethat islose their cellular walls and become displaced inwardthey metamorphose into the more obviously degenerate forms. Some of these clusters of balloon cells may become displaced into the deeper cortex by the generation of normal overlying fibers. It is also noteworthy that the process has a sectoral distribution corresponding to the spokelike configuration of the opacities seen in the gross specimen.h

Corticolysis: gCorticoh means gpertaining to cortexh and glysish means gdestruction, as of cells by a specific lysin.1h


Fig.2-1 Balloon cell formation by David G. Cogan4

Without a doubt, this gballoon cell formationh is the beginning of wedge-shaped cataracts. I am convinced that the balloon cell is an initial indicator of lens cell being crushed.

At the lens equator, pressure from the lens capsule has occurred. Therefore, the cause of wedge-shaped cataracts cannot be considered anything other than the pressure from the capsule. As it was assumed that the cause of wedge-shaped cataracts was the unnecessary pressure from the capsule during advanced age, for over past 20 years I strictly directed my patients to use reading glasses. As a result, I was able to stop the progression of wedge-shaped cataracts in almost all patients. I had been thinking that the cataract began as a simple crack of the lens cortex by the immoderate pressure. However, I found the literature of Cogan. His description was quite amazing. And it destroyed my view completely. I gave up the idea of a simple crack and restarted from Cogan's literature. From now on, I will call gthe pressure from the capsuleh gthe PRESSURE.h 

The Cause of Cataracts P.3