Histopathological Characteristics of Stellate-Shaped Anterior Subcapsular Cataract

A 31-year-old male presented with decreased vision in his left eye for two years following blunt ocular trauma. His left eye’s best-corrected visual acuity was 6/60 (plano) with an intraocular pressure of 21 mmHg. On examination, a stellate-shaped fibrous plaque was present under the anterior capsule [Figure 1a], along with a cataractous lens. The posterior segment was normal. Phacoemulsification cataract surgery with intraocular lens implantation was performed, resulting in a good postoperative visual acuity of 6/6(−1 DC ×160°). During the procedure, the continuous curvilinear capsulorhexis was conducted smoothly, with the capsule tearing easily through the arms of the fibrous plaque [Video 1]. Histopathology of the anterior capsule (with fibrous plaque) under 400× magnification [Figure 1b] revealed the following tissue layers from left to right: i. lens capsule (red arrow); ii. degenerated to focally intact inner cuboidal lining epithelium (black arrow). iii. subcapsular hydropic degeneration with accumulation of eosinophilic fluid and protein breakdown (blue arrow); iv. a band of fibrosis comprising spindle-shaped fibroblastic cells (yellow arrow). The lens epithelial cells undergo epithelial-mesenchymal transdifferentiation into myofibroblast cells, leading to the formation of subcapsular cataract or fibrosis in traumatic cataract (anterior subcapsular cataract).[1] This stellate-shaped subcapsular fibrosis suggests that it may be a long-term sequelae of the stellate[2] or petaloid cataract[3] that occurs following blunt trauma. {"href":"Single Video Player","role":"media-player-id","content-type":"play-in-place","position":"float","orientation":"portrait","label":"Video 1.","caption":"","object-id":[{"pub-id-type":"doi","id":""},{"pub-id-type":"other","content-type":"media-stream-id","id":"1_2xxg5uw4"},{"pub-id-type":"other","content-type":"media-source","id":"Kaltura"}]} Figure 1: (a): Stellate-shaped anterior subcapsular fibrosis in traumatic cataract. (b) histopathology of anterior capsular fibrosis under 400× magnification, showing the lens capsule (red arrow); degenerated to focally intact inner cuboidal lining epithelium (black arrow); subcapsular hydropic degeneration with accumulation of eosinophilic fluid and protein breakdown (blue arrow); and a band of fibrosis comprising spindle-shaped fibroblastic cells (yellow arrow)Declaration of patient consent The authors certify that they have obtained all appropriate patient consent forms. In the form the patient(s) has/have given his/her/their consent for his/her/their images and other clinical information to be reported in the journal. The patients understand that their names and initials will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed. Financial support and sponsorship Nil. Conflicts of interest There are no conflicts of interest.