PURPOSE To assess the correlation between clinical cataract surgery indication and the objective scatter index (OSI) by defining the optimal OSI cutoff point in the surgery scheduling. SETTING Ophthalmology service, Consorcio Hospital General Universitario, Valencia, Spain. DESIGN Prospective triple-masked randomized single-center study. METHODS Patients with cataractous eyes were recruited, and those with anterior segment disease, abnormal posterior pole, and/or previous ocular surgery were excluded. The principle of double-pass aberrometry was used by the main investigator to determine an OSI, after measuring subjective refraction and corrected distance visual acuity (CDVA), and then slitlamp evaluation was carried out by an independent researcher. The surgical decision was based on the current protocol according to the European guidelines. Correlation between the surgical decision, CDVA, and OSI were analyzed and an OSI discriminative value was calculated, implementing a receiver operating characteristic (ROC) curve. RESULTS The study comprised 106 eyes (73 patients). The analysis established an inverse linear correlation between OSI and CDVA (r = -0.455, P < .0001). The comparison of the mean OSI between the surgical group (7.05 ± 4.65 [SD]) and the nonsurgical group (2.92 ± 1.88), revealed statistically significant differences (P = 5.04 × 10-9). The OSI score 3.2 was determined as the optimal cutoff value to discriminate surgical treatment (sensitivity 80%, specificity 84%). CONCLUSIONS An optimal OSI value, according to an ROC curve calculation, was capable of providing clinicians with a powerful criterion for preoperative decision-making, thus suggesting an end to the subjectivity implicit in the cataract surgery decision-making process.

中文翻译：

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客观散布指数截止点是基于ROC分析的术前核白内障决策的有力客观标准。

目的通过定义手术计划中的最佳OSI临界点来评估临床白内障手术指征与客观散点指数（OSI）之间的相关性。设置眼科服务，西班牙瓦伦西亚康索里西奥综合大学综合医院。设计前瞻性三重掩盖随机单中心研究。方法招募白内障患者，排除前段疾病，后极异常和/或先前的眼科手术患者。在测量主观折射和校正后的远视力（CDVA）之后，主要研究人员使用两次像差测量原理确定OSI，然后由独立研究人员进行裂隙灯评估。根据欧洲指南，手术决定基于当前方案。分析了手术决策，CDVA和OSI之间的相关性，并计算了OSI判别值，从而实现了接收器工作特征（ROC）曲线。结果该研究包括106只眼（73例患者）。分析建立了OSI和CDVA之间的线性反比关系（r = -0.455，P <.0001）。手术组（7.05±4.65 [SD]）和非手术组（2.92±1.88）之间的平均OSI的比较显示出统计学上的显着差异（P = 5.04×10-9）。确定OSI评分3.2作为区分手术治疗的最佳临界值（敏感性80％，特异性84％）。结论根据ROC曲线计算得出的最佳OSI值能够为临床医生提供术前决策的有力依据，