Habib et al developed the Potential Difficulty Score (PDS) for describing the difficulty in performing phacoemulsification in a patient with a cataract. The authors are from the Sunderland Eye Infirmary in England.
Parameters:
(1) unable to lie flat
(2) severe anxiety
(3) head tremors
(4) previous angle closure glaucoma
(5) history of complications during surgery on the opposite eye
(6) previous vitrectomy with or without use of silicone oil
(7) corneal cloudiness
(8) shallow anterior chamber
(9) poor pupillary dilatation and/or posterior synaechiae
(10) pseudoexfoliation
(11) weak zonules (phacodonesis)
(12) axial length of the eye in mm
(13) cataract density
|
Parameter |
Finding |
Points |
|---|---|---|
|
unable to lie flat |
no (able to lie flat) |
0 |
|
|
yes |
1 |
|
severe anxiety |
absent |
0 |
|
|
present |
1 |
|
head tremors |
absent |
0 |
|
|
present |
1 |
|
previous angle closure glaucoma |
absent |
0 |
|
|
present |
1 |
|
history of complications during surgery on the opposite eye |
absent |
0 |
|
|
present |
1 |
|
previous vitrectomy |
absent |
0 |
|
|
present |
1 |
|
corneal cloudiness |
absent |
0 |
|
|
present |
1 |
|
shallow anterior chamber |
absent |
0 |
|
|
present |
1 |
|
poor pupillary dilatation and/or posterior synechiae |
absent |
0 |
|
|
present |
1 |
|
pseudoexfoliatin |
absent |
0 |
|
|
present |
1 |
|
weak zonules |
absent |
0 |
|
|
present |
1 |
|
axial length in mm |
< 20 mm (high hypermetropia) |
1 |
|
|
20 to 27 mm |
0 |
|
|
> 27 mm (high myopia) |
1 |
|
cataract density |
nuclear density Grade 1 or 2 |
1 |
|
|
nuclear density Grade 3 |
2 |
|
|
mature brunescent cataract |
3 |
total score =
= SUM(points for all 12 parameters)
Interpretation:
• minimum score: 1
• maximum score: 15
• The higher the score the more difficult the procedure.
Purpose: To evaluate a patient who will be undergoing a phacoemulsification using the Potential Difficulty Scale (PDS) of Habib et al.
Specialty: Ophthalmology
Objective: severity, prognosis, stage
ICD-10: H26.9,
