There is a scarcity of properly documented and classified human cataract material because of an abrupt shift of cataract surgical technique from intracapsular (intact lens) to extracapsular (fragmented lens) with the advent of the use of an intraocular lens. We are exploring ways by which fragmented lens materials can be maximally used in cataract basic research through close collaboration with cataract surgeons and basic researchers and through modification of techniques by both groups. We are now carefully documenting the cataracts preoperatively, using clinical and photographic LOCS II grading and Zeiss Scheimpflug and Oxford retroillumination video photography and image analysis. Cataracts are extracted extracapsularly with the implantation of an intraocular lens. This protocol, therefore, provides the laboratory with lens tissue from cataracts with disorders that would otherwise not be available such as gyrate atrophy, etc. The extracapsular extractions procedure provides the laboratory with essentially the whole lens, or at least most of it, which can be dissected into at least the inner layers of the cortex and the nuclear regions. This allows a much cleaner analysis of the proteins throughout the cataractous lens. We continue to refine our surgical technique to benefit patients (e.g., aim for myopic astigmatism so patients can see well both far and near without spectacles) as well as maximize the use of lens material obtained from surgery. In the laboratory, the initial step was to establish the two-dimensional gel electrophoresis, data collection, and analysis procedures. The two-dimensional gels provide a profile of the lens proteins separated by ionic charge and molecular weight. The next step was to map the crystallin species and their modifications throughout the cortex and the nuclear regions of normal lenses of various ages using donor eye bank eyes. Proteins in cataracts of different etiologies are now being studied.
