Clinical%20application%20of%20the%20Pentacam%20Scheimpflug%20system%20for%20lens%20density%20measurements%20in%20phacoemulsification

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Clinical application of the Pentacam Scheimpflug
system for lens density measurements in
phacoemulsification
So-Hyang Chung MD, PhD, Jung-Sub Kim MD
Choun-Ki, MD, PhD
Department of Ophthalmology and Visual
Science The Catholic University of Korea
No author has any financial interest
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Introduction

• Cataract classification and assessment
• Help making plan of the cataract surgery
• Investigate the possible risk factors of
  cataract formation
• Evaluate the performance of anti-cataract drugs

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Cataract assessment

• Subject method
• Lens opacity classification system LOCS III
• Wisconsin system
• Wilmer system
• Oxford system
• Object method Scheimpflug photography or
  slit-lamp imagery
• Oxford Scheimpflug
• Topcon SL-45
• Zeiss Scheimpflug video camera
• Nidek EAS-1000

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Pentacam
Densitometry Scale from 0 to 100
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Purpose

• To investigate the relationship between lens
  density measured with Pentacam Scheimpflug System
  preoperatively and phacodynamics (the amount of
  balanced salt solution, phacoemulsification
  energy and time) operatively in nuclear cataract
  patients.

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Material and Method

• Prospective study
• 60 eyes of 53 patients with nuclear cataract
• Preoperative evaluation of nuclear density
  thickness
• LOCS III grading scoring (0 7 points)
• NO, NC, C, P, AP
• Pentacam Scheimpflug system(0 100 points)
• The values for maximal score at the
  level of nucleus were chosen
• for analysis
• Infiniti phacoemulsification system (Alcon, TX,
  U.S.A)
• Ozil torsional handpiece through a
  microincisional 2.2mm clear
• corneal incision
• Torsional Amplitude, Torsional Time, Cumulated
  Dissipated
• Energy(CDE), Infusion fluid(BSS) amount

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Results
Pentacam Densitometry vs NO and NC score LOCIII
Positively correlated
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Results Pentacam Densitometry and NO and NC
score LOCS IIIvs Cumulated Dissipated Energy(CDE)
CDE had a stronger relationship with lens density
with Pentacam than with LOCS III NO or NC scores.
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Results Pentacam Densitometry and NO and NC
score LOCS III vs Amount of Balanced Salt Solution
No relationship between lens density and amount
of BSS
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Discussion

• Pentacam densitometry
• Correlate with LOCS III classification
• Useful tool to quantify lens status in the
  cataract patients preoperatively.
• More correlated with torsional time, torsional
  amplitude and CDE than LOCS III grade
• Limitation of Pentacam densitometry
• Anterior portion of lens masked due to
  mechanical artifact
• Posterior portion of lens uncheckable

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Conclusion

• Pentacam densitometry is simple and accurate
  objective documentation of cataract
• - contributes to more predictable and
  effective cataract surgery
• - contributes to customized cataract
  operation