Diagnostic Assessment of Nuclear Cataracts Using a Smartphone-Attachable Slit-Lamp Device: A Cross-Sectional Study in Vietnam

Purpose The purpose of this study was to compare the accuracy and agreement in nuclear cataract opacity classification between the Smart Eye Camera (SEC) device, and the slit-lamp. Methods A cross-sectional study was conducted with a convenient sampling of 221 eyes from 139 patients with phakic eyes, visiting IVISION Eye Center, Ho Chi Minh City, Vietnam, from November 1, 2023, to April 30, 2024. Two grading systems, Lucio-Buratto (Buratto) and World Health Organization (WHO), were used to compare the effectiveness of the two devices, with statistical analysis using Spearman's correlation coefficient and Cohen's kappa to evaluate the agreement level. Results Results showed no significant difference in Buratto and WHO grading between the two devices (p > 0.05), indicating consistency between the two measurement methods. Spearman's correlation coefficient demonstrated a strong correlation between the results from both devices, with r = 0.797 for Buratto and r = 0.579 for WHO (p < 0.001). The reliability was confirmed by high weighted-kappa values (k = 0.774 for Buratto and k = 0.539 for WHO). Conclusion The SEC's comparable effectiveness to the slit-lamp supports its potential utility in blindness-prevention screening efforts.