Human Anterior Lens Capsule As A Bioactive Scaffold For Ocular Surface Regeneration: Evidence From An In Vitro Wound Healing Model

Anterior lens capsules (ALC) are universally discarded during cataract surgery despite being collagen IV-rich native basement membranes with inherent regenerative potential. With over 30 million procedures annually, ALC represents a vast untapped biological resource. Current approaches for ocular surface disorders rely on amniotic membrane or synthetic scaffolds, each with limitations including availability, immunogenicity, and cost. This study is the first to systematically evaluate ALC as a bioactive scaffold for cellular migration in a standardized wound healing model, comparing its efficacy against purified commercial collagen IV to determine whether preserved three-dimensional matrix architecture confers superior regenerative capacity.

Department of Ophthalmology and Department of Medical Biology, Recep Tayyip Erdogan University Training and Research Hospital, a tertiary referral center in Rize, Turkey.

In this prospective experimental study, human ALC were collected from 12 eyes undergoing uneventful phacoemulsification for age-related cataract. Collagen IV content was confirmed by immunofluorescence with confocal microscopy. ARPE-19 cells were cultured to confluency and standardized scratch wounds (~500-600 μm) created. Three groups were established in quadruplicate: ALC (capsule fragments on wound), positive control (commercial collagen IV, 10 μg/cm²), and negative control (serum-free medium). Wound closure was documented at 0, 12, and 24h using phase-contrast microscopy and quantified with ImageJ by a blinded investigator. Cytotoxicity was assessed by MTT assay. One-way ANOVA with Tukey post-hoc test was used (p<0.05 significant).

Immunofluorescence confirmed intense, uniform collagen IV in all ALC specimens with intact basement membrane structure. At 24h, ALC achieved significantly superior wound closure (89.4±3.2%) vs positive control (85.1±4.1%, p=0.032) and negative control (83.6±3.8%, p<0.001), a 35% improvement in healing efficiency. Critically, native ALC outperformed purified collagen IV by 5.1%, demonstrating that preserved matrix architecture provides advantages beyond isolated components. Enhanced migration was evident at 12h (ALC 64.2±4.8% vs collagen IV 58.1±5.2% vs control 56.3±4.9%). ALC-treated cells exhibited organized directional migration with elongated morphology and prominent lamellipodia. MTT confirmed no cytotoxicity (cell viability 98.3±2.1%).

This study provides the first evidence that human ALC functions as a superior bioactive scaffold compared to purified collagen IV, establishing a novel “surgical waste-to-therapeutic resource” paradigm. Preserved basement membrane architecture delivers synergistic biological cues that cannot be replicated by isolated extracellular matrix components alone. With 30+ million capsules discarded annually, ALC offers an abundant, autologous, cost-effective, and immediately available biomaterial with translational potential for corneal epithelial defects, limbal stem cell deficiency, and post-surgical ocular surface complications. These findings open a new avenue in sustainable regenerative ophthalmology and warrant clinical translation.