Cell types of secondary cataract: an immunohistochemical analysis with antibodies to cytoskeletal elements and macrophages

Background: The study was carried out to identify cell types of secondary cataract after extracapsular cataract extraction and implantation of an intraocular lens. Methods: Twenty-five formalin-fixed, paraffin-embedded pseudophakic human eyes with secondary cataract, obtained at autopsy, were studied and compared to a specimen from an anterior subcapsular cataract with a panel of six monoclonal antibodies (MAbs, to vimentin, cytokeratin (CK) 8 and 18, desmin, alpha-smooth muscle actin, and the CD68 epitope of macrophages by the avidin-biotinylated peroxidase complex (ABC) method. Results: MAb Vim 3B4 to vimentin immunolabeled spindle-shaped cells in 16 of 17 central plaques of secondary cataract as well as cells in all 16 Soemmering's ring cataracts. Spindle-shaped cells reacted with MAb CAM 5.2 to CK 8 in 13 of 18 eyes, but only one specimen was labeled with MAb CY-90 to CK 18. No immunoreaction was seen with MAb D33 to desmin, whereas MAb 1A4 to alpha-smooth muscle actin immunolabeled spindle-shaped cells in 15 of 18 plaques of secondary cataract. Macrophages were seen with MAb PG-MI in 13 of 19 secondary cataracts. In the anterior subcapsular cataract, spindle-shaped cells under a wrinkled but otherwise intact capsule reacted with MAb Vim 3B4 to vimentin, MAb CAM 5.2 to CK 8, and MAb 1A4 to alpha-smooth muscle actin. Conclusion: Spindle-shaped cells in secondary and anterior subcapsular cataracts react with antibodies to vimentin, CK 8 and alpha-smooth muscle actin, sug gesting them to be metaplastic epithelial cells that derive from the lens epithelium. alpha-Smooth muscle actin persists in them at least 10 years postoperatively, but CK 8 starts to disappear after 3 years. Macrophages are one possible modulator of this transdifferentiation.