The correlation of nuclear density using the Lens Opacity Classification System III with Pentacam Scheimpflug imaging for predicting phacoemulsification parameters: A systematic review and meta-analysis

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Abstract Introduction: In this study, we systematically reviewed the literature to determine whether or not there was a correlation between lens density as measured by the Pentacam Scheimpflug System and grading score as determined by the Lens Opacities Classification System (LOCS) III in patients with age-related nuclear cataract. Methods: From 1990 to 2022, a systematic search was conducted in Medline (Ovid, PubMed), Embase, Scopus, Web of Science, ProQuest, and The Cochrane Library. Meta-analysis was performed for all observational studies that met the inclusion criteria. To assess the quality of cross-sectional and prospective studies, the JBI Checklist was used. To calculate the effect size for nuclear color (NC) and nuclear opalescence (NO), we used R programming software. In addition, we used Influence analysis to identify outliers and created forest plots with and without the detected outliers. Results: Among eight studies included in this systematic review, 965 patients with 1102 eyes were assessed with a mean age of 66.23 old years. The nuclear color and density were assessed in 4 and 6 studies, respectively. The odds ratio (OR) of the effect size was 0.72 with a 95% confidence interval (0.68, 0.76) for nuclear color, and the OR of the effect size was 0.94 with a 95% confidence interval (0.94, 0.95) for nuclear density both statistically significant. Conclusion: The Pentacam technique allowed for quantitative cataract grading and may aid in phacodynamics prediction during cataract surgery. The method is useful for detecting cataracts in patients and has broad potential in the field of health examination.

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