Correlations of Objective Metrics for Quantifying Dysfunctional Lens Syndrome With Visual Acuity and Phacodynamics

PURPOSE: To study the relationship between objective metrics for quantifying crystalline lens dysfunction with visual impairment and phacodynamics parameters in age-related nuclear cataracts. METHODS: A total of 51 eyes (34 patients) with age-related nuclear cataract had phacoemulsification. The Dysfunctional Lens Index (0 to 10 points) was measured by a ray-tracing aberrometry (iTrace Visual Function Analyzer; Tracey Technologies, Houston, TX). The average lens density (0 to 100) was evaluated using a rotating Scheimpflug system (Pentacam HR; Oculus Optikgeräte GmbH, Wetzlar, Germany), and the nuclear opalescence score was subjectively assessed using the Lens Opacities Classification System III (LOCS III). The different parameters for evaluating crystalline lens dysfunction were correlated with preoperative corrected distance visual acuity (CDVA) and cumulative dissipated energy (CDE). RESULTS: There was a negative linear correlation between the Dysfunctional Lens Index and the LOCS III nuclear opalescence and Scheimpflug-measured average density (r =-0.728 and r = -0.771, respectively; both P < .01). The preoperative CDVA was correlated with the Scheimpflug-measured lens nuclear density value (r = 0.612, P < .01) and Dysfunctional Lens Index score A (r =-0.670, P < .01). The CDE was more strongly correlated with Dysfunctional Lens Index and Scheimpflug-derived average density (r =-0.744 and r = 0.700, respectively; both P < .01) than with LOCS III nuclear opalescence (r = 0.646, P < .01). CONCLUSIONS: The Dysfunctional Lens Index was correlated with the Scheimpflug-measured average density, subjective lens grading, and preoperative CDVA. This metric also presented the highest correlation with phacodynamics. Correlation with other clinical measures related to visual quality and impairment are still needed. [J Cataract Refract Surg. 2017;33(2):79-83.].