Lens Density Research Articles

Lifetime Study in mice: radiation‐induced cataract

SummaryWe did a lifetime study in irradiated and control mice with a follow up time until 24 months post irradiation with repeated in vivo analysis of the lens density and the retina.Mice of different genetic constitution (wild‐type, Ercc2+/‐) were acutely whole body irradiated with low doses of ionising radiation (0, 63, 125 and 500 mGy) and a low dose rate (63 mGy/min). Lens opacification was analysed monthly by Scheimpflug imaging and the retinal fundus and thickness was analysed by OCT. At different time points (4 and 24 hours, 12, 18 and 24 months post irradiation) mice were sacrificed and eyes were analysed by histology and immunohistochemistry.Mice of all groups, even the DNA repair helicase deficient mice (Ercc2+/−), did not develop clinically relevant radiation‐dependent lens opacities. Only an age‐dependent increase of lens density was identified. Consequently, no major morphological changes were visible in the eye histology of all mice. Immunohistochemical staining against DNaseIIb revealed no differences between the groups as well as 8‐OHG staining resulted in similar ROS levels in all irradiation groups. However, non‐irradiated Ercc2+/‐ mice showed an increased level of oxidative stress compared to wild‐type mice.

Galaxy–galaxy lensing estimators and their covariance properties

We study the covariance properties of real space correlation function estimators -- primarily galaxy-shear correlations, or galaxy-galaxy lensing -- using SDSS data for both shear catalogs and lenses (specifically the BOSS LOWZ sample). Using mock catalogs of lenses and sources, we disentangle the various contributions to the covariance matrix and compare them with a simple analytical model. We show that not subtracting the lensing measurement around random points from the measurement around the lens sample is equivalent to performing the measurement using the lens density field instead of the lens over-density field. While the measurement using the lens density field is unbiased (in the absence of systematics), its error is significantly larger due to an additional term in the covariance. Therefore, this subtraction should be performed regardless of its beneficial effects on systematics. Comparing the error estimates from data and mocks for estimators that involve the over-density, we find that the errors are dominated by the shape noise and lens clustering, that empirically estimated covariances (jackknife and standard deviation across mocks) are consistent with theoretical estimates, and that both the connected parts of the 4-point function and the super-sample covariance can be neglected for the current levels of noise. While the trade-off between different terms in the covariance depends on the survey configuration (area, source number density), the diagnostics that we use in this work should be useful for future works to test their empirically-determined covariances.

Impact of lens densitometry on phacoemulsification parameters and usage of ultrasound energy in femtosecond laser-assisted lens surgery

ObjectiveThe aim of this study was to find the correlation between lens densitometry measurements using Pentacam Scheimpflug imaging system with equivalent average ultrasound power and cumulative dissipated energy (CDE) in femtosecond laser-assisted lens surgery (FLALS). MethodsOne hundred and twenty-four eyes were analyzed retrospectively, of which 109 had undergone cataract surgery and 15 had received refractive lens exchange with FLALS. Using the Pentacam Nucleus Staging (PNS) lens densitometry program, preoperative mean lens density and cataract grading score were evaluated. Average ultrasound power and CDE were recorded during surgery and correlated with the PNS grading and average lens density value. Exclusion criteria included small pupil size, previous ocular surgeries, tumors, optic atrophy, corneal scarring, intraoperative capsular rupture, and zonular dehiscence. ResultsPreoperative average lens density compared with CDE showed a weak significant positive linear correlation (p < 0.0001). CDE increased as lens density increased. This was also noticed when CDE and ultrasound time were compared with the PNS grading, demonstrating a significant moderate correlation (p < 0.0001). With increasing average lens density, the equivalent average ultrasound power showed a positive correlation (p < 0.0001). A weak positive correlation between estimated fluid use and PNS was also observed (p < 0.0001). Forty-one cases that did not require ultrasound energy during phacoemulsification had a PNS score between 0 and 1. ConclusionsThe Centurion Phacoemulsification machine has been shown to correlate positively with the Pentacam Scheimpflug System offering an objective and repeatable measure of lens density and cataract grading. This can aid in intraoperative phacodynamics and help reduce phacoemulsification complications, such as corneal endothelial injury.

Correlations of Objective Metrics for Quantifying Dysfunctional Lens Syndrome With Visual Acuity and Phacodynamics.

To study the relationship between objective metrics for quantifying crystalline lens dysfunction with visual impairment and phacodynamics parameters in age-related nuclear cataracts. A total of 51 eyes (34 patients) with age-related nuclear cataract had phacoemulsification. The Dysfunctional Lens Index (0 to 10 points) was measured by a ray-tracing aberrometry (iTrace Visual Function Analyzer; Tracey Technologies, Houston, TX). The average lens density (0 to 100) was evaluated using a rotating Scheimpflug system (Pentacam HR; Oculus Optikgeräte GmbH, Wetzlar, Germany), and the nuclear opalescence score was subjectively assessed using the Lens Opacities Classification System III (LOCS III). The different parameters for evaluating crystalline lens dysfunction were correlated with preoperative corrected distance visual acuity (CDVA) and cumulative dissipated energy (CDE). There was a negative linear correlation between the Dysfunctional Lens Index and the LOCS III nuclear opalescence and Scheimpflug-measured average density (r =-0.728 and r = -0.771, respectively; both P < .01). The preoperative CDVA was correlated with the Scheimpflug-measured lens nuclear density value (r = 0.612, P < .01) and Dysfunctional Lens Index score A (r =-0.670, P < .01). The CDE was more strongly correlated with Dysfunctional Lens Index and Scheimpflug-derived average density (r =-0.744 and r = 0.700, respectively; both P < .01) than with LOCS III nuclear opalescence (r = 0.646, P < .01). The Dysfunctional Lens Index was correlated with the Scheimpflug-measured average density, subjective lens grading, and preoperative CDVA. This metric also presented the highest correlation with phacodynamics. Correlation with other clinical measures related to visual quality and impairment are still needed. [J Cataract Refract Surg. 2017;33(2):79-83.].

Obesity and Density of the Crystalline Lens: Revisiting a Growing Dilemma

Background/Aims: Obesity is believed to accelerate age-related cataractogenesis through various biomechanisms. On the contrary, there are also studies advocating the protective role of obesity against the cataract formation process. We investigate the correlation of body mass index (BMI) as a measure for obesity with crystalline optical lens density and opacity in a healthy adult population. Methods: In a cross-sectional setting, 93 consecutive disease-free adult individuals who were working staff of a university-based hospital were assessed for the association between crystalline lens density and opalescence [measured by the objective Pentacam HR lens densitometry and subjective Lens Opacity Classification System III (LOCS III), respectively] with the degree of obesity as defined by BMI. Results: LOCS III and crystalline lens density readings were positively correlated [Spearman rho CC (p value) = 0.224 (0.034)]. However, we found neither LOCS III nor crystalline lens density to be correlated with BMI [Spearman rho CC = −0.008 (p = 0.943) and −0.062 (p = 0.560), respectively]. Conclusions: Results from the present study indicate a lack of association between obesity and densitometry of the crystalline in the adult population group. Further studies are required to confirm the order of causality and pathogenesis of this finding.

Preoperative and postoperative measurements of retinal vessel oxygen saturation in patients with different grades of cataracts.

To assess the retinal vessel blood oxygen saturation preoperatively and postoperatively in patients with different grades of cataracts. This study included 40 eyes from 40 patients with senile cataracts ranging from grade 1 to 3. All 40 eyes received standard phacoemulsification and intraocular lens implantation. The mean retinal arterial and venular oxygen saturation (SO2 ) levels were measured using the Oxymap system prior to, immediately after and 3months after cataract surgery. The arterial-venular difference (AVD) was calculated as the difference between the arterial and venular saturations. Linear regression analysis was performed to identify the relationship between the lens density grades and changes in the measured retina vessel SO2 . The mean age of the subjects was 64.1±7.8years, and 14 (35%) were male. The mean SO2 level increased in the retinal arterioles from 90.5±7.8% to 95.0±6.7% immediately postoperatively and to 98.3±5.3% at 3months after surgery (p<0.001). The mean venular saturation levels were 43.4±9.7%, 58.0±8.5% and 61.9±6.5% at baseline, immediately after and at 3months postoperatively, respectively, with a statistically significant increase after surgery (p<0.001). The mean AVD significantly decreased from 47.1±8.9% before surgery to 37.1±7.3% immediately after and 36.4±6.4% 3months after surgery (p<0.02). A linear regression model indicated that denser lens opacity was significantly associated with a larger amplitude of the venular SO2 level and the AVD after cataract surgery: change of venous SO2 =5.934-0.191×Age+13.534×Lens Grade (age: p=0.586; lens grade: p<0.001); change in AVD=-7.438-0.037×Age+7.744×Lens Grade (age: p=0.917; lens grade: p=0.031). Retinal arterial and venular oxygen saturation levels are significantly increased after cataract surgery, and increase rates vary with the preoperative grading of lens density.

Lens density measurements by two independent psychophysical techniques

BackgroundCataract, a leading cause of vision impairment, is due to the lens becoming excessively optically dense. Change in the lens optical density (LOD) could be a useful indicator of incipient nuclear cataract and would necessitate the development of accurate measurement techniques.Mapcat sf™ is a heterochromatic flicker photometer for measuring macular pigment optical density (MPOD) under photopic conditions. In the process, it also measures LOD that is needed in the calculation of MPOD. LOD is then converted by the instrument to “lens equivalent age” (LEA). However, varying cone photoreceptor ratios among individuals could affect the LEA measurement. Scotopic vision is mediated by rod photoreceptors; therefore, LEA measurement under scotopic conditions potentially provides a reliable standard for assessing other methods. The study was conducted to test the level of agreement between the LEA data obtained under photopic and scotopic conditions for a sample population. We also comment on factors that might contribute to any disagreement.MethodsLEAs were obtained by Mapcat sf for 25 subjects and compared with those obtained under absolute scotopic threshold conditions.ResultsThe mean scotopic LEA for the subjects was 2.7 years higher than the mean photopic LEA, but this difference was not statistically significant. Measurements by the two methods were reasonably correlated (r2 = 0.59, p < 0.0001). Significant individual differences in LEA by the two methods were found for six of the 25 subjects. Although our calculations included a standard long- to medium-wavelength-sensitive cone ratio, we found that different ratios could be found that rendered the differences in LEA insignificant for two of these six subjects. Variability in pupil diameter during scotopic measurements was considered another potential source of discrepancy between LEAs by the two methods.ConclusionThe absolute threshold technique, with long adaptation times, is probably impractical for routine lens density measurement, whereas Mapcat sf provided a rapid, straightforward test that may find its application in optometric/ophthalmic practice.

The effect of statin use on lens density as assessed by pentacam hr® lens densitometry in adults

Objective: To investigate the association between statin use and cataract development by using Pentacam HR Scheimpflug camera system. Material and Methods: Total 208 age and sex matched participants were included in this prospective, case-control study. 104 long-term statin users as study group and 104 non-statin users as control group constituted to the study. Lens densitometry measurements were performed with the Pentacam HR® (Oculus, Wetzlar, Germany) from three areas (anterior, nuclear, and posterior). These measurements were compared between the groups. Results: There were no significant difference at the basic clinical variables (p=0.121, p=0.778). The mean duration of statin use of the study group was 5,4±4,3 years. The mean value of lens densitometry measurement at nuclear area tended to be lower in statin users than controls, but difference was not statistically significant (9.20±1.00 vs 9.35±1.20; p:0.346). However, the mean lens densitometry values at the anterior and posterior areas of statin users were found to be significantly higher than controls (10.44±1.32 vs 9.16±1.09;p<0.001; 7.86±0.49 vs 7.63±0.38; p<0.001,respectively). Conclusion: The current study finds that long-term statin use seems to be associated with an increased risk of cortical cataracts (anterior-posterior) but not incidence of nuclear cataracts.

Lens density measurement with Scheimpflug camera in vitrectomised eyes

ObjectiveTo determine whether vitrectomised eyes have a higher lens optical density, when measured with a Scheimpflug camera, compared to non-vitrectomised eyes. MethodThe peak and linear Scheimpflug optical density (DOS), and area of both eyes were measured in a sample size of 81 vitrectomised phakic patients. A comparison was made between the DOS of the vitrectomised eye lens and the contralateral non-vitrectomised eye using the Student's t-test. ResultsA significantly higher linear DOS and area was obtained in the 81 vitrectomised phakic eyes when compared to the non-vitrectomised eyes (p<0.001). The peak DOS is not significantly increased in respect to non-vitrectomised eyes (p=0.59). ConclusionsThe lens DOS in vitrectomised eyes is higher than in non-vitrectomised eyes. The importance of the vitreous in the maintenance of lens transparency is emphasized.

Useful Prediction of Phacodynamics by Scheimpflug Lens Densitometry in Patients over Age 70

ABSTRACTPurpose: To evaluate the relationship between lens density using the Scheimpflug system and phacodynamics in nuclear cataracts as related to patient age. Methods: In 262 eyes with nuclear cataracts, the objective lens density was determined by Pentacam Nucleus Staging (PNS) software while subjective grading was achieved using the Lens Opacities Classification System III (LOCS III). Results: Overall, cumulated dissipated energy (CDE) had a positive correlation with Scheimpflug lens density and LOCS III nuclear scores. When analysis was done by patient age, LOCS III nuclear scores and Scheimpflug lens density had a positive correlation with CDE for patients in all age groups. Of interest, patients >70 years old showed a higher correlation coefficient (r) with Scheimpflug lens density than with LOCS III nuclear score. Conclusions: Scheimpflug lens densitometry may be more useful for predicting phacodynamics than LOCS III scores in nuclear cataract patients, especially in old age (>70 years).

Impact of the Femtosecond Laser in Line with the Femtosecond Laser-Assisted Cataract Surgery (FLACS) on the Anterior Chamber Characteristics in Comparison to the Manual Phacoemulsification

ABSTRACTPurpose: To assess the alterations of the anterior chamber conditions including laser flare photometry after femtosecond laser-assisted cataract surgery (FLACS) compared to the manual phacoemulsification. Methods: Data of n=70 FLACS (mean age 67.2 ± 8.9 years) and n=40 manual phacoemulsification (mean age 69.5 ± 9.6 years) were analyzed. The procedures were performed by LenSx Alcon, USA, and Alcon Infiniti Vision System, USA. The following parameters were recorded: laser flare photometry (Kowa FM 700, Japan), anterior chamber (AC) depth, AC volume, AC angle (Pentacam, Oculus Inc., Germany), lens density, pupil diameter, endothelial cell count and pachymetry. The analysis was performed preoperatively, immediately after femtosecond laser procedure and one day postoperatively. Results: Between FLACS and the phaco control group, there was a significant difference in the AC depth (p=0.023, 3.77 mm vs. 4.05 mm) one day postoperatively. The AC angle (p=0.016) showed a significant difference immediately after the femto laser treatment. The central and thinnest pachymetry and endothelial cell count did not show a significant difference between the two study cohorts (p=0.165, p=0.291, p=0.979). The phaco cohort (n=40) demonstrated a non-statistically significant difference in the flare photometry of 15.80 photons/ms one postoperative day compared to the FLACS group 26.62 photons/ms (p=0.322). Conclusion: In this study population, no evidence for an additive damage caused by the use of the femtosecond laser was demonstrated. Furthermore, no increase in the central and thinnest corneal thickness and no increased endothelial cell loss was demonstrated by the laser energy.

Heterochromatic Flicker Photometry for Objective Lens Density Quantification.

Although several methods have been proposed to evaluate lens transmittance, to date there is no consensual in vivo approach in clinical practice. The aim of this study was to compare ocular lens density and transmittance measurements obtained by an improved psychophysical scotopic heterochromatic flicker photometry (sHFP) technique to the results obtained by three other measures: a psychophysical threshold technique, a Scheimpflug imaging technique, and a clinical assessment using a validated subjective scale. Forty-three subjects (18 young, 9 middle aged, and 16 older) were included in the study. Individual lens densities were measured and transmittance curves were derived from sHFP indexes. Ocular lens densities were compared across methods by using linear regression analysis. The four approaches showed a quadratic increase in lens opacification with age. The sHFP technique revealed that transmittance decreased with age over the entire visual spectrum. This decrease was particularly pronounced between young and older participants in the short (53.03% decrease in the 400-500 nm range) wavelength regions of the light spectrum. Lens density derived from sHFP highly correlated with the values obtained with the other approaches. Compared to other objective measures, sHFP also showed the lowest variability and the best fit with a quadratic trend (r2 = 0.71) of lens density increase as a function of age. The sHFP technique offers a practical, reliable, and accurate method to measure lens density in vivo and predict lens transmittance over the visible spectrum. An accurate quantification of lens transmittance should be obtained in clinical practice, but also in research in visual and nonvisual photoreception.

Quantitative Scheimpflug camera study of the lens density in healthy Turkish population.

The purpose of this study is to evaluate the association between the age and the density of anterior, posterior, and nuclear parts of lens and detect the normal lens density (LD) values in different age groups. 370 eyes of 370 voluntary healthy Turkish subjects were included. These were divided in four groups according to their age. These were Group 1 (51-65years), Group 2 (41-50years), Group 3 (31-40years) and Group 4 (20-30years). LD values of anterior, nuclear, posterior, and total (average) were measured using Pentacam HR Scheimpflug camera system. Both eyes of each subject were scanned twice in automatic release and 50-picture3-dimensional (3D) scan modes by one experienced observer. 207 of the participants were females and 163 were males, with a mean age of 40.57±13.06years. The differences between groups in terms of nuclear area, posterior area, and average LD measurements were significant but anterior area was not. The nuclear area and average LD had high positive correlation with age (r=0.72, p<0.001, r=0.63, p<0.001, respectively); posterior area LD had a weak negative correlation with age (r=-0.16, p=0.001). The mean LD values between female and male subjects showed no significant difference. The anterior region of the lens has the highest and nuclear area has the lowest value of LD in young people. In older people, the anterior area did not show a significant change, nuclear and total areas showed a significant increase but posterior area showed a significant decrease.

Adjusting to a sudden “aging” of the lens

Color perception is known to remain largely stable across the lifespan despite the pronounced changes in sensitivity from factors such as the progressive brunescence of the lens. However, the mechanisms and timescales controlling these compensatory adjustments are still poorly understood. In a series of experiments, we tracked adaptation in observers after introducing a sudden change in lens density by having observers wear glasses with yellow filters that approximated the average spectral transmittance of a 70-year-old lens. Individuals were young adults and wore the glasses for 5 days for 8 h per day while engaged in their normal activities. Achromatic settings were measured on a CRT before and after each daily exposure with the lenses on and off, and were preceded by 5 min of dark adaptation to control for short-term chromatic adaptation. During each day, there was a large shift in the white settings consistent with a partial compensation for the added lens density. However, there was little to no evidence of an afterimage at the end of each daily session, and participants’ perceptual nulls were roughly aligned with the nulls for short-term chromatic adaptation, suggesting a rapid renormalization when the lenses were removed. The long-term drift was also extinguished by brief exposure to a white adapting field. The results point to distinct timescales and potentially distinct mechanisms compensating for changes in the chromatic sensitivity of the observer.

Density of the crystalline lens in obese and nonobese children

To compare crystalline lens density in obese and nonobese children. A total of 40 obese (25 females) and 46 age-sex matched controls (26 females) were included in this prospective study. Children with ocular diseases (except for mild refractive errors), ocular trauma, or surgery and any systemic disorders, including diabetes, were excluded. Lens densitometry (LD), central corneal thickness (CCT), anterior chamber depth (ACD) and corneal volume (CV) were measured by Pentacam HR. Mean participant age was 12.0±1.9 (range, 7.2-18years) in the obese group and 11.7±2.0 (range, 7.5-16.1years) in the control group. The BMI was 29.9±4.5 in the obese group and 18.7±2.5 in the control group (P≤0.05). The vertical, horizontal, and areal lens density measurements were higher in obese group than in controls (P≤0.05). There was a positive correlation between BMI and vertical, horizontal, and areal lens density measurements. The difference in CCT, ACD, and CV was not statistically significant between groups (P≥0.05). There is increased lens density in the obese children compared with controls. Pentacam HR may provide objective data about lens density in children.

Quantitative Analysis of Lens Nuclear Density Using Optical Coherence Tomography (OCT) with a Liquid Optics Interface: Correlation between OCT Images and LOCS III Grading.

Purpose. To quantify whole lens and nuclear lens densities using anterior-segment optical coherence tomography (OCT) with a liquid optics interface and evaluate their correlation with Lens Opacities Classification System III (LOCS III) lens grading and corrected distance visual acuity (BCVA). Methods. OCT images of the whole lens and lens nucleus of eyes with age-related nuclear cataract were analyzed using ImageJ software. The lens grade and nuclear density were represented in pixel intensity units (PIU) and correlations between PIU, BCVA, and LOCS III were assessed. Results. Forty-seven eyes were analyzed. The mean whole lens and lens nuclear densities were 26.99 ± 5.23 and 19.43 ± 6.15 PIU, respectively. A positive linear correlation was observed between lens opacities (R 2 = 0.187, p < 0.01) and nuclear density (R 2 = 0.316, p < 0.01) obtained from OCT images and LOCS III. Preoperative BCVA and LOCS III were also positively correlated (R 2 = 0.454, p < 0.01). Conclusions. Whole lens and lens nuclear densities obtained from OCT correlated with LOCS III. Nuclear density showed a higher positive correlation with LOCS III than whole lens density. OCT with a liquid optics interface is a potential quantitative method for lens grading and can aid in monitoring and managing age-related cataracts.

Optical densitometric measurements of the cornea and lens in children with allergic rhinoconjunctivitis

BackgroundOur aim was to investigate the impact of allergic rhinoconjunctivitis on corneal and lenticular optical densitometry, pachymetry and anterior chamber depth in children.MethodsFifty‐four patients who had allergic rhinoconjunctivitis (study group) and 54 age‐matched healthy children (control group) were recruited in this cross‐sectional and comparative study. Corneal and lenticular optical densitometry, pachymetry, corneal volume and anterior chamber depth measurements were taken with the Scheimpflug imaging system.ResultsThe lens density and anterior chamber depth were similar between the groups (p > 0.05), while corneal density and thickness were significantly higher in the study group (p < 0.05). Although the corneal volume was higher in children with allergic rhinoconjunctivitis, the difference was not statistically significant (p = 0.07).ConclusionsThe cornea is affected in allergic rhinoconjunctivitis in respect to optical density and thickness, while the anterior chamber and lens are not influenced.

Comparison of weak lensing by NFW and Einasto halos and systematic errors

Recent N-body simulations have shown that Einasto radial profiles provide the most accurate description of dark matter halos. Predictions based on the traditional NFW functional form may fail to describe the structural properties of cosmic objects at the percent level required by precision cosmology. We computed the systematic errors expected for weak lensing analyses of clusters of galaxies if one wrongly models the lens density profile. Even though the NFW fits of observed tangential shear profiles can be excellent, viral masses and concentrations of very massive halos (≳ 1015M⊙/h) can be over- and underestimated by 0∼ 1 per cent, respectively. Misfitting effects also steepen the observed mass-concentration relation, as observed in multi-wavelength observations of galaxy groups and clusters. Based on shear analyses, Einasto and NFW halos can be set apart either with deep observations of exceptionally massive structures (≳ 2×1015M⊙/h) or by stacking the shear profiles of thousands of group-sized lenses (≳ 1014M⊙/h).

Bionic intraocular lens with variable focus and integrated structure

This paper proposes a bionic accommodating intraocular lens (IOL) for ophthalmic surgery. The designed lens has a solid–liquid mixed integrated structure, which mainly consists of a support ring, elastic membrane, rigid lens, and optical liquid. The lens focus can be adjusted through the deformation of the lens front surface when compressed. The integrated structure of the IOL is presented, as well as a detailed description of the lens materials and fabrication process. Images under different radial pressures are captured, and the lens deformation process, accommodating range, density, and optical property are analyzed. The designed lens achieves a 14.6 D accommodating range under a radial pressure of 51.4 mN and a 0.24 mm alteration of the lens outer radius. The deformation property of the lens matches well with the characteristic of the eye and shows the potential to help patients fully recover their vision accommodation ability after the cataract surgery.

Objective assessment of cataract: Comparison between the Lens Opacities Classification System III and a Scheimpflug camera

PurposeDevelop an automatic system for cataract classification using the Sirius Scheimpflug for both nuclear and cortical cataract.MethodsScheimpflug images were taken using the Sirius system in 50 patients with nuclear and/or cortical cataract (mean age 69 ± 9.2 years). The nuclear opacity (NO) and cortical opacity was graded by an ophthalmologist according to the Lens Opacities Classification System (LOCSIII) by comparing the slit‐lamp image with the LOCS's standard nuclear images. A custom‐made MATLAB program was used to calculate the pixel intensity value within a region of interest (ROI) of the nucleus and to calculate the percentage of opaque pixels in the cortex.ResultsEighty‐nine eyes with nuclear and 81 eyes with cortical cataract were analysed. Both average and maximum NO pixel intensity units obtained from the ROI had a significant correlation with LOCS III (r = 0.731; P &lt; 0.01 and r = 0.738; P &lt; 0.01). The mean average NO was 21.77 ± 11.59 pixel intensity units and the mean maximum NO was 38.94 ± 18.52. A significant and positive correlation with LOCS III (r = 0.812; P &lt; 0.01) was found when the whole cortex area was analysed.ConclusionsThe results from this study indicate that the Sirius Scheimpflug has a good correlation with LOCS III for lens density measurements. The use of a Scheimpflug camera might be a valuable tool in clinical practice to grade nuclear and cortical cataracts automatically and objectively.