Eyeworld

109 EW RESIDENTS March 2016 References 1. Chylack LT Jr., et al. The Lens Opacities Classification System III. The Longitudinal Study of Cataract Study Group. Arch Ophthalmol. 1993 Jun;111(6):831–6. 2. Pei X, et al. Correlation of lens density measured using the Pentacam Scheimpflug system with the Lens Opacities Classification System III grading score and visual acuity in age-related nuclear cataract. Br J Ophthalmol. 2008 Nov;92(11):1471–5. 3. Sachdev N, et al. Higher-order aberrations of lenticular opacities. J Cataract Refract Surg. 2004 Aug;30(8):1642–8. 4. Lee J, et al. Higher-order aberrations in- duced by nuclear cataract. J Cataract Refract Surg. 2008 Dec;34(12):2104–9. Contact information Chow: jessica.chow@yale.edu significant" cataract as defined by their insurers (this may vary by geo- graphic location). Using methodolo- gies that expand the dimensions by which we can appraise a cataract's impact on vision, we can increase our sensitivity in identifying those patients whose quality of life can be markedly improved with cataract surgery. That is not to say, though, that all providers would be required to have a ray tracing aberrometer and lens densitometer to be able to ade- quately care for these patients. After all, these techniques are currently more relevant in the research setting than in the clinic. One significant finding in the foregoing study is that HOAs were positively correlated with lens densitometry. If this relationship holds in continued investigations, it would suggest that examining one parameter, such as lens densitometry, would suffice to infer the simultaneous presence of HOAs. As mentioned previously, an isolated measurement of lens den- sitometry is diagnostically relevant if it can be associated with a decline in visual function, whether it be a measurable decline in Snellen acuity or manifest in the measured HOAs. The authors also point out that lens densitometry may be helpful in planning a surgical approach. While the clinical appearance of a lens certainly provides substantial information about the nucleus den- sity, a densitometric measurement may be more reliable than clinical observation alone. This may impact a surgeon's preference of phaco technique and also the possibility of using a femtosecond laser to assist with lens fragmentation. However, plenty of room remains for further improvements and clarifications of current tech- niques. Of the various densitometric parameters available for measure- ment, it remains unclear which ones grant the most useful information regarding the functional status of the lens nucleus. Larger scale studies replicating and elaborating upon current techniques are likely to pro- vide relevant answers. Although lens densitometry measurements appear fairly reproducible for mild nuclear sclerosis, these measurements are less precise for higher-grade nuclear cataracts. EW with mild nuclear cataract" From left: Peter Ryg, MD, Tiffany Liu, MD, Lucy Zhang, MD, Alexander Nguyen, MD, and Jessica Chow, MD Source: Yale School of Medicine

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