{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,5]],"date-time":"2026-02-05T07:36:56Z","timestamp":1770277016184,"version":"3.49.0"},"reference-count":14,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,6,12]],"date-time":"2025-06-12T00:00:00Z","timestamp":1749686400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100007816","name":"Alcon","doi-asserted-by":"publisher","award":["IIT#87839903"],"award-info":[{"award-number":["IIT#87839903"]}],"id":[{"id":"10.13039\/100007816","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec><jats:title>Introduction<\/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 Centurion under gravity mode. In this randomized controlled trial, we compared these two systems\u2019 impact on high myopia patients\u2019 macular blood perfusion under different IOP settings. To evaluate intra-op and post-op clinical performance of the Alcon Centurion with Active Sentry and under gravity mode in cataract patients with eye axial lengths &amp;gt; 26 mm.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Fifty-two eyes of 43 cataract patients with axial lengths &amp;gt; 26\u202fmm were enrolled and randomly divided into the active fluidics system (AFS) group using a Centurion Active Sentry handpiece under 30\u202fmmHg IOP setting (26 eyes) and the gravity fluidics system (GFS) group in gravity mode under 80 cmH<jats:sub>2<\/jats:sub>O IOP setting (26 eyes). Intraoperative parameters, visual acuity, parafoveal macular vessel density and macular thickness 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), macular thickness, cumulative dissipated energy (CDE), total case time, as well as ophthalmic viscoelastic devices (OVDs) usage between the two groups. However, we found less pain complaints during surgeries and a more stable macular vessel density post-surgery in the AFS group than in the GFS group, implying higher intraoperative comfort levels and less retinal ischemia during cataract surgery using Centurion with Active Sentry under low IOP settings.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Owing to a lower IOP setting, Centurion Vision System with Active Sentry handpiece causes less retinal ischemia and pain perception during phacoemulsification for high myopia patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Clinical trial registration<\/jats:title><jats:p><jats:uri>https:\/\/www.chictr.org.cn<\/jats:uri>, identifier ChiCTR2400080875.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fmed.2025.1554832","type":"journal-article","created":{"date-parts":[[2025,6,12]],"date-time":"2025-06-12T05:20:49Z","timestamp":1749705649000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":4,"title":["Surgical outcomes of phacoemulsification with different fluidics systems (centurion with active sentry vs. centurion gravity) in cataract patients with eye axial length above 26\u202fmm"],"prefix":"10.3389","volume":"12","author":[{"given":"Yinan","family":"Liu","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xiaoyong","family":"Chen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2025,6,12]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"e7","DOI":"10.1097\/IJG.0000000000000527","article-title":"Influence of large intraocular pressure reduction on Peripapillary OCT vessel density in ocular hypertensive and Glaucoma eyes","volume":"26","author":"Holl\u00f3","year":"2017","journal-title":"J Glaucoma"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"4175","DOI":"10.1007\/s10792-021-01987-8","article-title":"Optical coherence tomography angiography evaluation of the effects of phacoemulsification cataract surgery on macular hemodynamics in Chinese normal 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system","volume":"41","author":"Zhao","year":"2021","journal-title":"Int Ophthalmol"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"205","DOI":"10.5935\/0004-2749.20220093","article-title":"Dynamic changes in retinal vessel density observed by optical coherence tomography angiography after phacoemulsification: active vs gravity fluidics system","volume":"85","author":"Liu","year":"2022","journal-title":"Arq Bras Oftalmol"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"58","DOI":"10.18240\/ijo.2018.01.11","article-title":"Effect of infusion pressure during cataract surgery on ganglion cells measured using isolated-check visual evoked potential","volume":"11","author":"Ding","year":"2018","journal-title":"Int J Ophthalmol"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"1024","DOI":"10.1076\/ceyr.16.10.1024.9024","article-title":"Effects of changes in intraocular pressure on human ocular haemodynamics","volume":"16","author":"Findl","year":"1997","journal-title":"Curr Eye Res"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"2207","DOI":"10.2147\/OPTH.S53223","article-title":"Retinal thickness changes after phacoemulsification","volume":"7","author":"Pardianto","year":"2013","journal-title":"Clin Ophthalmol"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"282","DOI":"10.1111\/j.1442-9071.2011.02638.x","article-title":"Prevalence of optical coherence tomography-diagnosed postoperative cystoid macular oedema in patients following uncomplicated phaco-emulsification cataract surgery","volume":"40","author":"Vukicevic","year":"2012","journal-title":"Clin Experiment Ophthalmol"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"408","DOI":"10.1159\/000073070","article-title":"Incidence of cystoid macular edema after uncomplicated phacoemulsification","volume":"217","author":"Mentes","year":"2003","journal-title":"Ophthalmologica"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"1080","DOI":"10.1016\/S0886-3350(02)01993-4","article-title":"Outcomes of phacoemulsification in patients with and without pseudoexfoliation syndrome","volume":"29","author":"Shingleton","year":"2003","journal-title":"J Cataract Refract Surg"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"687","DOI":"10.3980\/j.issn.2222-3959.2012.06.07","article-title":"Effect of simulated dynamic intraocular pressure on retinal thickness measured by optical coherence tomography after cataract surgery","volume":"5","author":"Chen","year":"2012","journal-title":"Int J Ophthalmol"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"641","DOI":"10.4103\/0301-4738.169786","article-title":"Effect of fluidics on corneal endothelial cell density, central corneal thickness, and central macular thickness after phacoemulsification with torsional ultrasound","volume":"63","author":"Das","year":"2015","journal-title":"Indian J Ophthalmol"}],"container-title":["Frontiers in Medicine"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2025.1554832\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,6,12]],"date-time":"2025-06-12T05:20:50Z","timestamp":1749705650000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fmed.2025.1554832\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,6,12]]},"references-count":14,"alternative-id":["10.3389\/fmed.2025.1554832"],"URL":"https:\/\/doi.org\/10.3389\/fmed.2025.1554832","relation":{},"ISSN":["2296-858X"],"issn-type":[{"value":"2296-858X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,6,12]]},"article-number":"1554832"}}