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Title: Changes in the content of selected bioelements in cataractous human lens of patients with glaucoma and diabetes


Cataract is an eye disease most often impairing vision. According to the WHO half of the cases of blindness are caused by this disease, which corresponds to about 20 million people. The only effective cure for cataract is surgical treatment, and cataract removal is the most commonly performed surgical procedure in the world. Interest in the role of bioelements in human lenses is due to their likely effect on the onset and progression of pathological changes. Hitherto all lenses obtained during the ECCE (extracapsular cataract extraction) have been the main source of research. The quantitative statistics of studies on bioelements in lenses and described cases in literature are very limited. This is due to the fact that cataract removal surgery, during which the entire lens is removed, is rare. The prevalence of microincision surgery with phacoemulsification almost entirely led to the withdrawal of surgeons from the ECCE, which resulted in a lack of research material. The aim of the study is to determine the content of bioelements in cataractous human lenses and to correlate the obtained results with selected diseases. Additionally, the content of bioelements in the cataractous lens at which the diabetic and glaucoma are present in the studied population is further defined.Prospective studies included 101 operations in 101 patients (65.3% of women and 34.7% of men) aged 56 to 100 years, mean age 74.8 ± 8.6 years. Patients included in the study were operated on for cataract in two hospitals: the 5th Military Hospital with Polyclinic in Cracow and the Military Medical Institute in Warsaw in the period 2013-2015. The material after the operation was delivered to the Institute of Nuclear Physics of the Polish Academy of Sciences in Cracow for further analytical studies. Therefore, the appropriately prepared material obtained after phacoemulsification was used for the study. This material is conventionally disposed of and is not subjected to any research processes. The samples were not subjected to initial chemical treatment. A single measurement allowed the examination of the content of many elements simultaneously. Patients with diagnosed cataracts were included. Based on an interview and indicated treatment, three groups of patients were identified: Group G1 ‒ 37 cataract patients not treated for diabetes and glaucoma ‒ mean age = 75.6 ± 9.8 years (60-100 years); Group G2 ‒ 25 patients with cataract treated for diabetes ‒ mean age = 73.6 ± 8.1 years (59-88 years); G3 group ‒ 39 patients with cataract treated for glaucoma ‒ mean age = 74.2 ± 8.4 years (56-93 years). In this study we focused on three elements: calcium (Ca), iron (Fe) and zinc (Zn). ; None of the groups met the criteria for normal distribution, as confirmed by the Schapiro-Wilk test. Distribution of the examined feature included various numbers of measurements and were characterized by considerably differing variations. There were also markedly outlying observations. In this situation, the statistical significance of the differences was examined by the Kruskal-Wallis nonparametric test (with a significance level of 0.05). The significance of intra-group differences was evaluated by the Dunn test. The interdependence analysis included age, best corrected visual acuity, intraocular pressure and bioelements content. A correlation matrix has been created. A set of variable derivatives was then prepared to take into account not only raw variables, but also their transformations such as logarithm. Strong correlations (ranging from 0.75 to 1.0 or -0.75 to -1.0) were observed only within groups of variables of the same origin, for example, the zinc content and its transformations. The other correlations between variables from different groups were low or very low. The following results were obtained in the bioelements content of cataractous lenses in particular groups of patients: Ca content (median values): 425 ppm (G1), 472 ppm (G2), 768 ppm (G3); Fe content (median values): 5 ppm (G1), 6 ppm (G2), 2.8 ppm (G3); Zn content (median values): 39 ppm (G1), 63 ppm (G2), 153 ppm (G3). The relationships and differences in bioelements between the groups of patients were shown. Elevated levels of zinc and iron have been observed for patients treated for diabetes, which is consistent with other published data. On the other hand, samples from glaucoma patients showed the highest Zn content, often reaching values of several hundred ppm. In case of glaucoma it was impossible to refer to other studies because there is no literature on this topic. For any of the elements studied, no significant differences in the medians of gender have been found. All p values were significantly higher than the assumed significance level of 0.05. The p levels were as follows: for zinc 0.2319, for iron 0.9227 and for calcium 0.9204. Using the decision tree method, the percentage and probability of diabetes and glaucoma were determined based on the content of zinc, iron and calcium in the lens. High calcium (above 449 ppm) and zinc (above 80 ppm) levels were observed among glaucoma patients and elevated iron levels (above 16 ppm) in diabetic patients. ; The current research suggests new directions in medical diagnosis because cataract removal is the most commonly performed surgical procedure in the world. The application of the PIXE method has shown numerous advantages over other methods of determining the content of bioelements due to its high accuracy, ease of sample preparation and large amount of information obtained from a single study. Based on the studies conducted in the 101 patients with diabetes or glaucoma or none of these diseases, the following conclusions were drawn:1. Disease (diabetes, glaucoma) affects the content of bioelements (Ca, Fe, Zn) in cataractous lenses. The highest Zn content was found in the samples taken from the lens of glaucoma patients.2. Correlation analysis did not confirm the relationship between all the factors involved.3. Gender does not affect the content of bioelements (Ca, Fe, Zn) in opaque lenses. 4. Decision analysis indicated elevated iron content above 16 ppm in opaque lenses in patients with diabetes mellitus, and in the case of glaucoma patients, a high calcium content of over 449 ppm and zinc above 80 ppm was observed.

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2 - studia doktoranckie

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Uniwersytet Jagielloński. Collegium Medicum. Wydział Nauk o Zdrowiu.


Małgorzata Schlegel-Zawadzka ; Katarzyna Lewczuk

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Biblioteka Medyczna Uniwersytetu Jagiellońskiego- Collegium Medicum

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May 24, 2021

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Mar 16, 2018

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ZB-127387 May 24, 2021


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