Lens Opacities Classification System III: cataract grading variability between junior and senior staff at a Singapore hospital.
ABSTRACT To test the reliability of the Lens Opacities Classification System III (LOCS III) cataract grading between observers at different levels of ophthalmology experience.
Ophthalmology Department, National University Hospital, Singapore, Singapore.
In this comparative study, a non-ophthalmology trainee, a basic ophthalmology trainee, and an ophthalmology consultant graded cataracts in 28 patients preoperatively. The observers had a meeting to discuss their interpretations of the LOCS III manual to standardize the grading system and then graded 37 additional patients.
There was a statistically significant increase in inter-observer agreement in all 3 LOCS III categories after standardization of the LOCS III system. The kappa values after standardization fell in the moderate (0.41 to 0.60) to substantial (0.61 to 0.80) range. There was no statistically significant relationship between the observer's experience and the kappa values.
There was an increase in inter-observer agreement in all categories after standardization between operators.
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ABSTRACT: Cataract affects more than 20 million people worldwide and is the leading cause of vision loss. Currently, the phacoemulsification is the most used procedure to extract cataract and recover visual acuity. Optimal phacoemulsification energy is demanded for safety cataract removal. It is well established that the energy value is determined by the cataract hardness. In this study twenty porcine eyes were used as experimental samples. Cataract was induced by an ethanol:2-propanol:formalin solution. A 25 MHz focused transducer has been used to estimate the ultrasound velocity and attenuation. Statistical analysis was performed to compare the different used methodologies and to correlate the different ultrasound parameters with different stages of cataract formation (lens hardness).IEEE International Ultrasonics Symposium (IUS), Dresden, Germany; 10/2012
- Expert Review of Ophthalmology 01/2014; 4(5).
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ABSTRACT: To evaluate objectively intraocular scattering in eyes with nuclear, cortical and posterior subcapsular cataracts by means of an objective scatter index (OSI) obtained from double-pass images. To compare the results with those obtained using clinical conventional procedures. In this prospective, observational, cross-sectional, non-consecutive case series study, 188 eyes with cataracts of 136 patients were analysed (123 eyes had nuclear, 41 eyes had cortical and 24 eyes had posterior subcapsular cataracts). The control group consisted of 117 eyes of 68 healthy patients. Patient examination included subjective refraction, best spectacle-corrected visual acuity (BSCVA), cataract grade using the lens opacities classification system III (LOCS III) and OSI. We found a decrease in the BSCVA and an increase in the OSI with increasing cataract grade. Statistically significant differences were observed when the OSI of eyes without cataracts and those with different LOCS III were compared. The comparison between the OSI and LOCS III reported good percentages of agreement regarding the number of eyes classified in equivalent levels: 72.4% (nuclear cataracts), 86.6% (cortical cataracts) and 84.3% (posterior subcapsular cataracts). A non-linear regression model was applied between OSI and BSCVA, which resulted in the following multiple correlation coefficients: r=0.878 (nuclear), r=0.843 (cortical) and r=0.844 (posterior subcapsular). The results of the study showed that OSI is a useful parameter for evaluating large amounts of intraocular scattering that can be used, in combination with other conventional procedures, as a valuable tool in clinical practice to grade cataracts objectively.The British journal of ophthalmology 07/2012; 96(9):1204-10. · 2.92 Impact Factor