{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,5]],"date-time":"2026-06-05T01:54:33Z","timestamp":1780624473098,"version":"3.54.1"},"reference-count":27,"publisher":"Wiley","license":[{"start":{"date-parts":[[2022,5,17]],"date-time":"2022-05-17T00:00:00Z","timestamp":1652745600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Journal of Ophthalmology"],"published-print":{"date-parts":[[2022,5,17]]},"abstract":"<jats:p>Purpose. To evaluate sutureless scleral tunnel phaco-assisted cataract extraction in regards to the cumulative dissipated energy (CDE) used, the resulting endothelial cell loss (ECL), and the surgically induced astigmatism (SIA) in advanced cataracts. Methods. A prospective interventional uncontrolled case series was performed. Patients with advanced cataracts according to the Lens Opacities Classification System III (LOCS III) had sutureless scleral tunnel phaco-assisted cataract extraction. They were followed up one week, one month, and 3 months postoperatively for SIA and ECL. The used CDE was recorded. Results. The study included 198 eyes: 36 eyes (18.2%) with LOCS III grade nuclear opalescence (NO4) cataracts, 102 eyes (51.5%) with LOCS III grade NO5, and 60 eyes (30.3%) with LOCS III grade NO6. Three months postoperatively, the mean SIA was 0.94\u2009\u00b1\u20090.71D. The endothelial cell density (ECD) was reduced significantly to 2341.31\u2009\u00b1\u2009471 cells\/mm2 (<jats:inline-formula>\n                     <a:math xmlns:a=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M1\">\n                        <a:mi>p<\/a:mi>\n                        <a:mo>=<\/a:mo>\n                        <a:mn>0.0001<\/a:mn>\n                     <\/a:math>\n                  <\/jats:inline-formula>) with a mean ECL of 5.39%. The mean CDE and ECL% were 0.174\u2009\u00b1\u20090.46 U\/S (2.07%), 0.859\u2009\u00b1\u20090.42 U\/S (5.01%), and 2.306\u2009\u00b1\u20090.89 U\/S (8.01%) in LOCS III grade NO4, NO5, and NO6, respectively. The overall mean CDE was 1.17\u2009\u00b1\u20090.99 U\/S, which was significantly correlated with the ECL (<jats:inline-formula>\n                     <c:math xmlns:c=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M2\">\n                        <c:mi>p<\/c:mi>\n                        <c:mo>=<\/c:mo>\n                        <c:mn>0.0001<\/c:mn>\n                     <\/c:math>\n                  <\/jats:inline-formula>). Conclusion. Sutureless scleral tunnel phaco-assisted cataract extraction in advanced cataracts enabled reduction in CDE with good preservation of the ECD and acceptable SIA.<\/jats:p>","DOI":"10.1155\/2022\/4272571","type":"journal-article","created":{"date-parts":[[2022,5,17]],"date-time":"2022-05-17T18:20:16Z","timestamp":1652811616000},"page":"1-6","source":"Crossref","is-referenced-by-count":6,"title":["Endothelial Cell Loss, Cumulative Dissipated Energy, and Surgically Induced Astigmatism in Sutureless Scleral Tunnel Phaco-Assisted Cataract Extraction in Advanced Cataracts"],"prefix":"10.1155","volume":"2022","author":[{"given":"Marwa M.","family":"Salama","sequence":"first","affiliation":[{"name":"Assistant Professor of Ophthalmology, Cairo University, Giza, Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sherif A.","family":"GamalElDin","sequence":"additional","affiliation":[{"name":"Professor of Ophthalmology, Cairo University, Giza, Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9632-1292","authenticated-orcid":true,"given":"Malak I.","family":"ElShazly","sequence":"additional","affiliation":[{"name":"Assistant Professor of Ophthalmology, Cairo University, Giza, Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","reference":[{"key":"1","doi-asserted-by":"publisher","DOI":"10.1155\/2017\/3849152"},{"key":"2","doi-asserted-by":"publisher","DOI":"10.5301\/ejo.5000413"},{"key":"3","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajo.2018.08.006"},{"key":"4","doi-asserted-by":"publisher","DOI":"10.1038\/srep13123"},{"key":"5","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0152088"},{"key":"6","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcrs.2017.01.010"},{"key":"7","doi-asserted-by":"publisher","DOI":"10.1097\/icu.0000000000000219"},{"key":"8","doi-asserted-by":"publisher","DOI":"10.1001\/archopht.1993.01090060119035"},{"key":"9","doi-asserted-by":"publisher","DOI":"10.1097\/icu.0b013e32835b0770"},{"key":"10","volume-title":"The Alpins method: a breakthrough in astigmatism analysis","author":"K. 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