Correlation of nuclear density using the Lens Opacity Classification System III versus Scheimpflug imaging with phacoemulsification parameters.

Purpose: To grade nuclear cataracts using the Lens Opacity Classification System III (LOCS III) and the correlation with maximum nuclear density on Scheimpflug imaging and phacoemulsification parameters.

Setting: Tertiary care center.

Design: Longitudinal interventional study.

Methods: The nuclear density of significant age-related cataracts was evaluated by comparing slitlamp images with standard photographic charts of the LOCS III system. Maximum nuclear density was calculated using a Scheimpflug imaging system (Pentacam). All patients had phacoemulsification and posterior chamber intraocular lens implantation. Intraoperatively, parameters (eg, phaco time, power consumed, balanced salt solution used) were noted and compared with different grades of cataract and maximum nuclear densities.

Results: One hundred patients with visually significant age-related cataract were evaluated. There was a positive linear correlation between the LOCS III grading and Scheimpflug maximum nuclear density (P<.001). The LOCS III grading and Scheimpflug maximum nuclear density had a linear correlation with preoperative corrected distance visual acuity (r = 0.588 and r = 0.525, respectively), cumulative dissipated energy (CDE) (r = 0.607 and r = 0.847, respectively), total ultrasound (US) time (r = 0.627 and r = 0.802, respectively), and fluid used (r = 0.623 and r = 0.678, respectively).

Conclusion: Both systems had a linear correlation with total US power, CDE, and fluid used; however, the Scheimpflug imaging system had a stronger correlation with these phacoemulsification parameters.