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Purpose: To compare anterior chamber stability and surgical efficiency in one-handed phacoemulsification, comparing Ozil and Active Sentry (AS) handpieces. Methods: Observational and comparative study. Selected patients were divided into two groups, AS and Ozil handpieces, and underwent one-handed phacoemulsification. Parameters like IOP per quadrant, vacuum, and aspiration flow were fixed in all surgeries. The study endpoints were intraoperative anterior chamber instability score (IACIS), cumulative dissipated energy (CDE), followability, and surgery duration. Results: Mean age was 71.42 years in the AS group vs. 73.97 in the Ozil Group. Mean Axial Length was 22.85 ± 1.21 mm with Active Sentry vs. 23.3 ± 1.29 mm with Ozil (p = 0.324). IACIS was 0.10 ± 0.30 with AS vs. 0.63 ± 0.71 with Ozil (˂0.001*). CDE was 9.95 ± 4.76 percent-seconds with AS vs. 10.89 ± 6.55 percent-seconds with Ozil (0.519). The followability score was 0.74 ± 0.855 with AS vs. 0.83 ± 0.874 with Ozil (p = 0.678). Surgery duration was 19.00 ± 5.44 min with AS vs. 24.57 ± 6.51 with Ozil (p < 0.001). Conclusions: The Active Sentry handpiece improves anterior chamber stability in one-handed phacoemulsification while maintaining surgical performance during nucleus removal without an auxiliary side-port. To the best of our knowledge, this is the first study demonstrating that the Active Sentry handpiece can increase anterior chamber stability not only in conventional phacoemulsification but also in one-handed phacoemulsification. [ABSTRACT FROM AUTHOR]

Purpose: To compare anterior chamber stability and surgical efficiency in one-handed phacoemulsification, comparing Ozil and Active Sentry (AS) handpieces. Methods: Observational and comparative study. Selected patients were divided into two groups, AS and Ozil handpieces, and underwent one-handed phacoemulsification. Parameters like IOP per quadrant, vacuum, and aspiration flow were fixed in all surgeries. The study endpoints were intraoperative anterior chamber instability score (IACIS), cumulative dissipated energy (CDE), followability, and surgery duration. Results: Mean age was 71.42 years in the AS group vs. 73.97 in the Ozil Group. Mean Axial Length was 22.85 ± 1.21 mm with Active Sentry vs. 23.3 ± 1.29 mm with Ozil (p = 0.324). IACIS was 0.10 ± 0.30 with AS vs. 0.63 ± 0.71 with Ozil (˂0.001*). CDE was 9.95 ± 4.76 percent-seconds with AS vs. 10.89 ± 6.55 percent-seconds with Ozil (0.519). The followability score was 0.74 ± 0.855 with AS vs. 0.83 ± 0.874 with Ozil (p = 0.678). Surgery duration was 19.00 ± 5.44 min with AS vs. 24.57 ± 6.51 with Ozil (p < 0.001). Conclusions: The Active Sentry handpiece improves anterior chamber stability in one-handed phacoemulsification while maintaining surgical performance during nucleus removal without an auxiliary side-port. To the best of our knowledge, this is the first study demonstrating that the Active Sentry handpiece can increase anterior chamber stability not only in conventional phacoemulsification but also in one-handed phacoemulsification.

Objective: Phacoemulsification is the predominant method for cataract surgery, but complications like lens nuclei dislodgment into the vitreous cavity pose significant risks, including inflammation, glaucoma, retinal tears, and vision loss. Traditional management involves pars plana vitrectomy with phacofragmentation, which can increase the risk of retinal damage due to repulsive forces. This study tests whether the OZil phacoemulsification handpiece, employing torsional movement, offers a safer alternative by minimizing repulsive forces and reducing surgical duration compared to the traditional phacofragmatome., Methods: This prospective study, conducted in a tertiary care hospital in eastern India from January to June 2023, enrolled 40 patients with nucleus dislocation during cataract surgery. Patients were randomized into Group 1 (traditional phacofragmatome) and Group 2 (OZil handpiece). Primary objectives included comparing the duration of surgery and intraoperative complications. Secondary objectives assessed postoperative best-corrected visual acuity (BCVA), surgical site safety, and cystoid macular edema (CME) incidence., Results: Group 2 demonstrated significantly shorter surgical durations (110±2.54 seconds) compared to Group 1 (152±2.23 seconds, p < 0.001). The frequency of nucleus falls was considerably lower in Group 2 (p < 0.001). Postoperative BCVA and CME incidence showed no significant differences between groups. Multiple regression analysis confirmed the OZil handpiece significantly reduced surgical duration (β = -0.40, p < 0.001) without compromising safety., Discussion: The OZil handpiece's rotational cutting mechanism offers a significant advantage in reducing surgical time while improving the followability of lens fragments, as compared to the traditional phacofragmatome. It addresses one of the key limitations of phacofragmentation by minimizing fragment displacement, where repulsive forces can complicate the procedure. Although both techniques showed similar safety profiles, the OZil handpiece's operational efficiency makes it a promising alternative for managing posteriorly displaced lens fragments in complex cases., Conclusions: The OZil phacoemulsification handpiece significantly enhances surgical efficiency and safety in nucleus drop surgeries. Its integration into existing phacofragmatome systems can lead to major advancement in the ophthalmic surgical armamentarium, ensuring improved patient care., Competing Interests: The authors state no conflict of interest regarding the research, authorship, and/or publication of this article., (© 2024 The Authors.)

Background/aim The present study aims to compare postoperative endothelial outcome after cataract surgery performed with longitudinal phacoemulsification with that performed with torsional phacoemulsification in patients with senile cataract. Patients and methods In this prospective observational study, 20 eyes with senile cataract of different grades of nuclear hardness underwent phacoemulsification by means of a 2.8-mm clear corneal incision using Ozil IP, 10 of which underwent torsional phacoemulsification and 10 underwent longitudinal phacoemulsification. Central endothelial cell counts were taken in all patients preoperatively, at 1 week, 1 month, and 3 months postoperatively. Results The study included 20 patients with age-related cataract whose ages ranged from 55 to 64 years. There was highly statistically significant endothelial cell loss throughout the study in the two groups and also significant endothelial cell loss between the two groups by the third month (P = 0.02). Conclusion Both torsional and longitudinal phacoemulsification techniques were efficient in removing noncomplicated cataract; however, statistically significant endothelial cell loss was noted, especially with longitudinal phacoemulsification.

Background/aim The present study aims to compare postoperative endothelial outcome after cataract surgery performed with longitudinal phacoemulsification with that performed with torsional phacoemulsification in patients with senile cataract. Patients and methods In this prospective observational study, 20 eyes with senile cataract of different grades of nuclear hardness underwent phacoemulsification by means of a 2.8-mm clear corneal incision using Ozil IP, 10 of which underwent torsional phacoemulsification and 10 underwent longitudinal phacoemulsification. Central endothelial cell counts were taken in all patients preoperatively, at 1 week, 1 month, and 3 months postoperatively. Results The study included 20 patients with age-related cataract whose ages ranged from 55 to 64 years. There was highly statistically significant endothelial cell loss throughout the study in the two groups and also significant endothelial cell loss between the two groups by the third month (P = 0.02). Conclusion Both torsional and longitudinal phacoemulsification techniques were efficient in removing noncomplicated cataract; however, statistically significant endothelial cell loss was noted, especially with longitudinal phacoemulsification. [ABSTRACT FROM AUTHOR]

Purpose: To assess the relationship between postoperative endothelial cell loss and microcoaxial phaco parameters using Ozil IP (Alcon Laboratories, Inc, Fort Worth, TX) in noncomplicated cataract surgery. Methods: In this prospective observational study, 120 consecutive cases of cataract patients with different grades of nuclear hardness underwent microcoaxial phacoemulsification through a 2.2-mm clear corneal incision. An Alcon Infinity Vision System with Ozil IP (Alcon Laboratories) was used with an Ozil torsional handpiece and a Kelman-style 45° phacoemulsification tip. Patients underwent preoperative and postoperative central endothelial cell counts. Results: The study included 120 cases of age-related cataract whose mean age (standard deviation [SD]) was 59.68 years (9.47). There was a highly statistically significant endothelial cell loss (P < 0.001). The endothelial cell loss ranged 11-1149 cells/mm2 with a median (interquartile range) of 386 cells/mm2 (184.5-686 cells/mm2). The percentage of postoperative ECLoss% ranged from 0.48% to 47.8% with a median (interquartile range) of 15.4% (7.2% to 26.8%). A significant positive correlation was found between the ECLoss% and different phaco parameters. The Spearman's rank-order correlation coefficient values, rho, (ρ) were as follows: CDE (ρ = 0.425), aspiration time (ρ = 0.176), and volume (ρ = 0.278). Also, ECLoss% was significantly correlated with the grade of nuclear opalescence (Kendall's tau τ = 0.42). Conclusion: Microcoaxial phacoemulsification was efficient in removing noncomplicated cataracts; however a statistically significant endothelial cell loss was noted, especially with increased nuclear hardness. This endothelial cell loss was mostly related to the increased cumulative dissipated energy (CDE), aspiration time, and volume of balanced salt solution used. [ABSTRACT FROM AUTHOR]

Background: The purpose of this study was to compare phacoemulsification energy parameters during torsional phacoemulsification with or without the use of intelligent phacoemulsification (IP) software., Methods: One hundred and twenty-eight eyes with nuclear grades ranging from 1 to 5 were enrolled in this randomized prospective study. Operated eyes were divided into two groups, ie, those operated on using IP software (Group 1, n = 67) and those operated on without IP software (Group 2, n = 61). The two groups were compared in terms of ultrasound energy level, ultrasound energy time, aspiration time, and amount of fluid used during surgery., Results: Operated eyes were further grouped according to soft (grade 1 and 2, n = 37), medium (grade 3, n = 46), and hard (grade 4 and 5, n = 31) nuclear densities. Both the study and the control groups were similar in distribution of nuclear density (P > 0.05). Cumulative dissipated energy was measured as 14.06 ± 9.92 in Group 1 and 14.22 ± 10.99 in Group 2 (P = 0.92). Total ultrasound time was 49 seconds in Group 1 and 52 seconds in Group 2 (P = 0.58). Although the torsional amplitude used was similar (P = 0.86) when IP was either on (71%) or off (68.4%), aspiration time was found to be 4 minutes 17 seconds in Group 1 (P = 0.86) and 5 minutes and 17 seconds in Group 2 (P = 0.007). Total fluid used was measured as 91 cc (P = 0.86) in Group 1 and 109 cc (P = 0.02) in Group 2., Conclusion: The new IP software did not cause a difference in ultrasound energy levels. However, the new software was found to be advantageous in regards to fluid use and aspiration time.