The authors of this letter propose an interesting mechanism for the observed relationship between axial length and nuclear cataract reported in a study published in the November 2006 issue of Archives of Ophthalmology. These researchers believe that vitreous syneresis, which is proportional to axial length and increases vitreous fluid circulation, allows greater access to the lens of molecular oxygen from the retinal surface. When this occurs, the lens may undergo oxidative damage that leads to nuclear cataract formation in a process similar to cataract development following vitrectomy when fluid replaces the intact vitreous gel that normally diffuses oxygen.
The authors of the November 2006 study wrote a reply to the letter in which they concurred with the hypothesis that vitreous liquefaction spurs nuclear cataract development by increasing oxygen levels in the eye. They conclude that further research is necessary to confirm the theory's accuracy.
Dr. Arbisser has received honoraria and research grants from Alcon Laboratories Inc. and Advanced Medical Optics Inc.