{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T01:39:04Z","timestamp":1760060344196,"version":"build-2065373602"},"reference-count":15,"publisher":"MDPI AG","issue":"16","license":[{"start":{"date-parts":[[2025,8,20]],"date-time":"2025-08-20T00:00:00Z","timestamp":1755648000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Purpose: To evaluate the efficiency and safety of high-fluidics ultrasound emulsification using slim-shaft-strong-bevel (SSSB) tip technology for nucleus workup through mini- and micro-incisions. Materials and Methods: 77 patients underwent immediate sequential bilateral cataract surgery using high-flow-high-vacuum easyTip\u00ae2.2 (\u201ceT2.2\u201d) or infusion-assisted (\u201cHybrid\u201d) easyTip\u00aeCOMICS (\u201ceT1.6 iaCOMICS\u201d) coaxial phacoemulsification. Surgical time (ST), Effective Phacoemulsification Time (EPT), and fluid consumption (FC), central corneal thickness (CCT), and endothelial cell count (ECC) were recorded. Results: 50 patients completed the 6 months follow-up. Preoperatively, groups did not differ in nuclear hardness, CCT, or ECC. The median ST for Conquer with eT2.2 phaco was 49 s, with eT1.6 iaCOMICS phaco 57 s (p = 0.021). The median total EPT was 8.3 and 8.0 (p = 0.882), and the median EPT for Conquer was 4.0 and 4.1, respectively (p = 0.812). The median FC for Conquer was 21 mL with the eT2.2 and 22 mL with the eT1.6 iaCOMICS phaco (p = 0.29), and the overall FC was 29 mL and 33 mL, respectively (p = 0.105). Mean CCT was 561 \u00b1 42 \u00b5m and 563 \u00b1 45 \u00b5m on day 1 (p = 0.835), 539 \u00b1 33 \u00b5m and 542 \u00b1 34 \u00b5m at 1 week (p = 0.714), and 536 \u00b1 31 \u00b5m and 541 \u00b1 33 \u00b5m at 6 months (p = 0.55), respectively. Mean ECL at 6 months was 2.80 \u00b1 7.28% and 3.41 \u00b1 8.25% (p = 0.725). Conclusions: When compared to previously published results obtained with a standard non-waisted phaco needle and lower fluidics and with the waisted easyTip\u00ae2.2 run with intermediate fluidics, ultrasound-assisted high-fluidics phacoaspiration with the easyTip\u00ae2.2 through a 2.2 mm incision and the easyTip\u00ae COMICS through a 1.6 mm incision with infusion-assistance significantly improved efficiency of nucleus workup by reducing ultrasound energy and infusion fluid consumption, with minimal transient corneal stroma swelling and low endothelial cell loss.<\/jats:p>","DOI":"10.3390\/jcm14165887","type":"journal-article","created":{"date-parts":[[2025,8,20]],"date-time":"2025-08-20T15:53:37Z","timestamp":1755705217000},"page":"5887","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["\u201cUltrasound-Assisted High-Fluidics Phacoaspiration\u201d: An Efficient and Safe Technique for Nucleus Quadrant Workup Through 2.2 mm Mini- and 1.6 mm Micro-Incisions Following Manual or Femtosecond Laser Sectorial Lens Fragmentation"],"prefix":"10.3390","volume":"14","author":[{"given":"Rupert Michael","family":"Menapace","sequence":"first","affiliation":[{"name":"Department of Ophthalmology, Medical University of Vienna, A-1090 Vienna, Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sabine","family":"Schriefl","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Medical University of Vienna, A-1090 Vienna, Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-8241-5435","authenticated-orcid":false,"given":"Silvio","family":"Di Nardo","sequence":"additional","affiliation":[{"name":"Institute of Medical Engineering, Lucerne University of Applied Sciences and Art, CH-6048 Horw, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,8,20]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Ali\u00f3, J., and Fine, H. 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Surg."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"1325","DOI":"10.1097\/j.jcrs.0000000000001032","article-title":"Effect of simulated lenticular debris on corneal endothelial cells: Experimental study in rabbit eyes","volume":"48","author":"Wilkinson","year":"2022","journal-title":"J. Cataract Refract. Surg."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1440","DOI":"10.1097\/j.jcrs.0000000000001052","article-title":"Corneal endothelium protection provided by ophthalmic viscosurgical devices during phacoemulsification: Experimental study in rabbit eyes","volume":"48","author":"Park","year":"2022","journal-title":"J. Cataract Refract. Surg."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"e414","DOI":"10.1111\/aos.14983","article-title":"Ultrasound energy consumption and macular changes with manual and femtolaser-assisted high-fluidics cataract surgery: A prospective randomized comparison","volume":"100","author":"Menapace","year":"2022","journal-title":"Acta Ophthalmol."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/14\/16\/5887\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T18:32:14Z","timestamp":1760034734000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/14\/16\/5887"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,8,20]]},"references-count":15,"journal-issue":{"issue":"16","published-online":{"date-parts":[[2025,8]]}},"alternative-id":["jcm14165887"],"URL":"https:\/\/doi.org\/10.3390\/jcm14165887","relation":{},"ISSN":["2077-0383"],"issn-type":[{"type":"electronic","value":"2077-0383"}],"subject":[],"published":{"date-parts":[[2025,8,20]]}}}