Causes of cataract progression in glaucoma patients (report 2)

Hypotensive drops that penetrate into the aqueous humor of the anterior chamber cause thinning, roughness, irregularities, and microcracks in the anterior lens capsule, followed by the formation of microfibrils and pseudomembranes. In a five-year follow-up of 2532 glaucoma patients, nuclear cataract progression due to prolonged use of hypotensive eye drops was identified in 592 cases (23.4%).Patients with glaucoma exhibit a lower oxygen consumption rate by the lens (2.27 femtomoles/min/cell vs. a normal value of 2.83 femtomoles/min/cell), reduced oxygen utilization for adenosine triphosphate (ATP) production (0.72 femtomoles/min/cell vs. a normal value of 0.932 femtomoles/min/cell), and decreased maximal respiratory capacity of lens cells (4.17 vs. 5.46 femtomoles/min/cell). These changes represent risk factors for cataract development.In uveal glaucoma, blood proteins and inflammatory cells accumulate in the aqueous humor, posterior synechiae form between the iris and the anterior lens capsule, and fibrinous exudate develops in the pupillary area. Patients with uveal glaucoma receive anti-inflammatory and hypotensive pharmacotherapy, as well as laser and surgical treatments, including drainage device implantation. These factors contribute to a 34% increase in the incidence and progression of cataracts in uveal glaucoma patients.