Lens Opacities Classification System III: cataract grading variability between junior and senior staff at a Singapore hospital.

PURPOSE

To test the reliability of the Lens Opacities Classification System III (LOCS III) cataract grading between observers at different levels of ophthalmology experience.

SETTING

Ophthalmology Department, National University Hospital, Singapore, Singapore.

METHODS

In this comparative study, a non-ophthalmology trainee, a basic ophthalmology trainee, and an ophthalmology consultant graded cataracts in 28 patients preoperatively. The observers had a meeting to discuss their interpretations of the LOCS III manual to standardize the grading system and then graded 37 additional patients.

RESULTS

There was a statistically significant increase in inter-observer agreement in all 3 LOCS III categories after standardization of the LOCS III system. The kappa values after standardization fell in the moderate (0.41 to 0.60) to substantial (0.61 to 0.80) range. There was no statistically significant relationship between the observer's experience and the kappa values.

CONCLUSIONS

There was an increase in inter-observer agreement in all categories after standardization between operators.