Comparison of Dysfunctional Lens Index and Scheimpflug Lens Densitometry in the Evaluation of Age-Related Nuclear Cataracts

PURPOSE: To describe the Dysfunctional Lens Index (DLI) from ray-tracing aberrometry and to test its correlations with logMAR corrected distance visual acuity (CDVA) and lens grading based on the Lens Opacities Classification System III (LOCS III) and the Scheimpflug-based lens density. METHODS: The DLI was calculated by the i-Trace Visual Functional Analyzer (Tracey Technologies, Houston, TX). Forty eyes of 30 patients with mild to moderate age-related nuclear cataract were included retrospectively. Nuclear opalescence grading was obtained by slit lamp using the LOCS III, and objective lens densitometry was evaluated by Scheimpflug imaging (Pentacam HR; Oculus Optikgeräte GmbH, Wetzlar, Germany). The average density parameter obtained by Scheimpflug imaging of the nucleus lens was considered. RESULTS: The DLI showed a high negative linear correlation with the LOCS III nuclear opalescence score (r = -0.662; P < .01). The average density of the lens nucleus was positively correlated with the LOCS III nuclear opalescence score (r = 0.682; P < .01). The CDVA had a stronger relationship with the DLI parameter (r = -0.702, P < .01) compared to the average density values (r = 0.630, P < .01). CONCLUSIONS: The DLI was correlated with the LOCS III nuclear opalescence score and the Scheimpflug-based lens density. The DLI had a stronger correlation with CDVA compared to the LOCS III classification or the Scheimpflug-based lens density. The DLI may improve the preoperative evaluation of nuclear cataract and the monitoring of its progression.