Clinical Outcomes Of Cataract Surgery Using Centurion® Active Fluidics System With Low Iop Setting In Eyes With A Low Corneal Endothelial Cell Density

To evaluate the surgical outcomes of cataract surgery utilizing Alcon Active Sentry system (ASS) in eyes with low corneal endothelial cell density (ECD) and shallow anterior chamber.

Tokyo Dental College, Ichikawa General Hospital, Chiba, Japan.

A prospective chart review was conducted in accordance with Tokyo Dental College Institutional Review Board policy. 14 eyes with preoperative ECD less than 2000 cells/mm² and anterior chamber depth less than 2mm, undergoing cataract surgery using Centurion® with ASS between 2022 and 2023, were included (ASS group). Simultaneously, 20 patients with preoperative ECD less than 2000 cells/mm² and anterior chamber depth less than 2mm, undergoing cataract surgery using Centurion® without ASS between 2021 and 2023 were retrospectively assessed as the control group. Standard phacoemulsification with intraocular lenses was performed using the soft-shell technique.

Log MAR corrected distance visual acuity (CDVA) significantly improved from 0.17 ± 0.17 to 0.03 ± 0.21(P = 0.03) in ASS group, and from 0.37 ± 0.47 to -0.05 ± 0.05 (P = 0.014) in control group. In ASS group, the mean ECD significantly decreased from 1343.6 ± 301 cells/mm² to 1122.8 ± 537.4cells/mm²(P=0.011). In control group, the mean ECD was not significantly decrease from 1049.5 ± 321.4 cells/mm² to 850.8 ±222.8 cells/mm² (P=0.19). The mean rate of ECD loss was 20.7% in ASS group and 21.5% in control group (P=0.73). 1 eye (5%) developed bullous keratopathy in ASS group.

The results suggest that cataract surgery with ASS can provide excellent visual rehabilitation in many patients with low preoperative ECD and a shallow anterior chamber. However, no significant advantage was observed with cataract surgery using ASS.