{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,4]],"date-time":"2026-11-04T22:48:16Z","timestamp":1793832496075,"version":"4.6.1"},"reference-count":12,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2023,11,23]],"date-time":"2023-11-23T00:00:00Z","timestamp":1700697600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>During cataract phacoemulsification surgery, the Alcon Centurion with Active Sentry can achieve a more stable anterior chamber, which allows a lower intraocular pressure (IOP) setting than the gravity fluidics system. In this randomized controlled trial, we compared these two systems\u2019 damage to the cornea under different IOP settings.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Seventy-eight eyes of 53 patients with corneal endothelial cell density (ECD) of 500\u223c1500\/mm<jats:sup>2<\/jats:sup> were enrolled and randomly divided into the active fluidics system (AFS) group using an Active Sentry handpiece with 30 mmHg IOP setting (40 eyes) and the gravity fluidics system (GFS) group using an Ozil handpiece with 80 cmH<jats:sub>2<\/jats:sub>O IOP setting (38 eyes). Intraoperative parameters, visual acuity, corneal edema ratio, central corneal thickness (CCT) changes as well as loss rate of ECD were analyzed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We observed no significant differences in best corrected visual acuity (BCVA), cumulative dissipated energy (CDE), total case time, estimated fluidics usage (EFU) and ophthalmic viscoelastic devices (OVDs) usage between the two groups. The enrolled eyes were further divided into soft nucleus (27 eyes) and hard nucleus (51 eyes) subgroups. And we found less pain complaint during surgeries, lower corneal edema ratio at 1-day and 1-week visit, smaller CCT changes at 1-day visit and lower ECD loss rate at 1-month visit (<jats:italic>p<\/jats:italic> &amp;lt; 0.05) in both subgroups of the AFS group than in the GFS group, implying higher intraoperative comfort levels and less corneal damage of the AFS group with a low IOP setting.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Owing to a lower IOP setting, Centurion<jats:sup>\u00ae<\/jats:sup> Vision System with Active Sentry handpiece causes less corneal damage and pain perception during phacoemulsification for patients with low pre-operative ECD.<\/jats:p><\/jats:sec><jats:sec><jats:title>Clinical Trial Registration<\/jats:title><jats:p><jats:ext-link>https:\/\/www.chictr.org.cn<\/jats:ext-link>, identifier ChiCTR2300077865.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fmed.2023.1294808","type":"journal-article","created":{"date-parts":[[2023,11,26]],"date-time":"2023-11-26T08:28:30Z","timestamp":1700987310000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":19,"title":["Comparisons of the clinical outcomes of Centurion\u00ae active fluidics system with a low IOP setting and gravity fluidics system with a normal IOP setting for cataract patients with low corneal endothelial cell density"],"prefix":"10.3389","volume":"10","author":[{"given":"Yinan","family":"Liu","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jing","family":"Hong","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaoyong","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2023,11,23]]},"reference":[{"key":"B1","first-page":"90","article-title":"[Corneal endothelial damage and its repair after phacoemulsification].","volume":"40","author":"Xie","year":"2004","journal-title":"Zhonghua Yan Ke Za Zhi."},{"key":"B2","doi-asserted-by":"publisher","first-page":"247","DOI":"10.1016\/j.jcrs.2009.09.023","article-title":"Comparison of endothelial cell loss after cataract surgery: phacoemulsification versus manual small-incision cataract surgery: six-week results of a randomized control 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anesthesia.","volume":"26","author":"Hou","year":"2012","journal-title":"Eye."},{"key":"B6","doi-asserted-by":"publisher","first-page":"1491","DOI":"10.1016\/j.jcrs.2018.01.032","article-title":"Phacoemulsifier occlusion break surge volume reduction.","volume":"44","author":"Thorne","year":"2018","journal-title":"J Cataract Refract Surg."},{"key":"B7","author":"Hong","year":"2019","journal-title":"Corneal endothelial disease."},{"key":"B8","doi-asserted-by":"publisher","first-page":"1079","DOI":"10.1016\/S0886-3350(96)80121-0","article-title":"Risk factors for corneal endothelial injury during phacoemulsification.","volume":"22","author":"Hayashi","year":"1996","journal-title":"J Cataract Refract Surg."},{"key":"B9","doi-asserted-by":"publisher","DOI":"10.1186\/s12886-023-02954-w","article-title":"Effect of elevated irrigation bottle height during cataract surgery on corneal endothelial cells in porcine eyes.","volume":"23","author":"Wenzel","year":"2023","journal-title":"BMC Ophthalmol."},{"key":"B10","doi-asserted-by":"publisher","first-page":"106","DOI":"10.1016\/j.exer.2017.06.008","article-title":"Near infra-red light attenuates corneal endothelial cell dysfunction in situ and in vitro.","volume":"161","author":"N\u00fa\u00f1ez-\u00c1lvarez","year":"2017","journal-title":"Exp Eye Res."},{"key":"B11","doi-asserted-by":"publisher","first-page":"157","DOI":"10.1016\/j.jcrs.2015.08.017","article-title":"Experimental anterior chamber maintenance in active versus passive phacoemulsification fluidicsics systems.","volume":"42","author":"Nicoli","year":"2016","journal-title":"J Cataract Refract Surg."},{"key":"B12","doi-asserted-by":"publisher","first-page":"880","DOI":"10.1016\/S0886-3350(00)00757-4","article-title":"Patient pain during different stages of phacoemulsification using topical anesthesia.","volume":"27","author":"O\u2019Brien","year":"2001","journal-title":"J Cataract Refract Surg."}],"container-title":["Frontiers in Medicine"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2023.1294808\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,11,26]],"date-time":"2023-11-26T08:28:32Z","timestamp":1700987312000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2023.1294808\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,11,23]]},"references-count":12,"alternative-id":["10.3389\/fmed.2023.1294808"],"URL":"https:\/\/doi.org\/10.3389\/fmed.2023.1294808","relation":{},"ISSN":["2296-858X"],"issn-type":[{"value":"2296-858X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,11,23]]},"article-number":"1294808"}}