Clinical importance of the lens opacities classification system III (LOCS III) in phacoemulsification.

The aim of this study was to compare the correlation of features of cataracts graded by the Lens Opacities Classification System, version III (LOCS III) with recorded operative characteristics during the phacoemulsification. The retrospective study included 245 cases operated on by a single surgeon from October 2003 to March 2004. The cataract was graded at the biomicroscope using the 4 grading scales of the lens opacities classification system, version III (LOCS III); nuclear opalescence (NO), nuclear color (CO), cortical cataract (C) and posterior subcapsular cataract (P). We recorded 2 intraoperative characteristics: machine measured phacoemulsification time, and average machine power. The machine recorded phacoemulsification time and average power correlated positively with the estimated nuclear color (NC) scale and nuclear opaclescence (NO) scale. Grading within categories of cortical cataract (C) and posterior subcapsular cataract (P) did not correlate with any of the operative variables. Exponentially, greater phacoemulsification energy was required as NC and NO increased. LOCS III grading system enables the surgeon to anticipate potential pitfalls and to adapt the operative technique to the individual patient.